Risk factors and treatment for steroid-related mood and behavior symptoms in preschool children with leukemia: A case series

Abstract

Treatment of pediatric acute lymphoblastic leukemia (ALL) relies on systemic corticosteroids for remission; however, they can cause significant mood and behavior changes that interfere with quality of life and may increase risk for injury. This case series reports on preschool children with preexisting developmental and psychiatric risk factors who presented with behavioral side effects that required intervention. Identification of these vulnerable children may provide opportunities for early intervention, anticipatory guidance, and effective treatment to minimize behavioral side effects and improve quality of life and safety during ALL treatment.

Measuring neurobehavioral side effects of corticosteroids in pediatric acute lymphoblastic leukemia: A scoping review

“…Full‐text assessment for eligibility was conducted on the remaining 71 studies. Ultimately, 24 studies met the eligibility criteria and were included in the review 13,15,16,20–39 …”

“…The current review revealed a variety of measures used to assess neurobehavioral side effects in the pediatric population undergoing corticosteroid treatment. Among the different methods of measurement identified in the included articles, clinical assessment and description was the most commonly used, utilized in seven articles 15,16,30,35–38 . Sleep was evaluated by a combination of formalized measures, 13,20,29 actinography, 20,24–26,32 sleep diaries, 21,25 and wearable technology (Micromini Motionlogger Sleep Watch) 24 …”

“…Ultimately, 24 studies met the eligibility criteria and were included in the review. 13,15,16,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The current review revealed a variety of measures used to assess neurobehavioral side effects in the pediatric population undergoing corticosteroid treatment. Among the different methods of measurement identified in the included articles, clinical assessment and description was the most commonly used, utilized in seven articles.…”

“…Among the different methods of measurement identified in the included articles, clinical assessment and description was the most commonly used, utilized in seven articles. 15,16,30,[35][36][37][38] Sleep was evaluated by a combination of formalized measures, 13,20,29 actinography, 20,[24][25][26]32 sleep diaries, 21,25 and wearable technology (Micromini Motionlogger Sleep Watch). 24 Of the 12 validated scales identified (Table 1), the Pediatric Qualityof-Life Inventory (PedsQL) was most frequently used, utilized in four articles.…”

The impact of parental overprotection on the emotions and behaviors of pediatric hematologic cancer patients: a multicenter cross-sectional study

“…Manijeh et al’s study indicated that younger children show higher sensitivity to pain ( Firoozi and Rostami, 2012 ). Moreover, preschool-age children are more prone to experiencing neurobehavioral side effects when undergoing treatment with corticosteroids; this tendency may be attributed to the incomplete development of their brain regulatory systems, which makes them more susceptible to the adverse effects of corticosteroids ( Mrakotsky et al, 2011 ; Samsel and Muriel, 2017 ).…”