Neurotoxicity of chemotherapeutic and biologic agents in children with cancer

Braganca, Kevin C. De; Packer, Roger J.

doi:10.1007/s11910-008-0019-9

Cited by 4 publications

(4 citation statements)

References 54 publications

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“…This is similar to the findings by E. MartinezCayuelas, et al, where 30% of their patients had sensory and motor type complications (18). In our study, in a sample of 32 patients, the distribution was approximately 25 (80%) patients with a sensory type, 11 (34%) patients with a motor type and 13 (40%) individuals with autonomic type.…”

Section: Discussionsupporting

confidence: 92%

“…However, most of our patients have cumulative dose of this drug, which has been linked to the risk of chemotherapy-induced neuropathy. Another example, is methotrexate, which shows that high doses, greater than 1.5 g/m 2 is related to adverse effects (18). Some of the chemotherapeutic agents established in therapy for ALL such as ARA-C, have yet to establish the cumulative doses for risk of peripheral neurotoxicity (19,20).…”

Section: Discussionmentioning

confidence: 99%

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Chemotherapy-Induced Peripheral Neuropathy in a Subpopulation of Mexican Pediatric Patients with Acute Lymphoblastic Leukemia

et al. 2017

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Background: Chemotherapy-induced peripheral neuropathy (CIPN) is frequent in children with acute lymphoblastic leukemia (ALL). Neurological manifestations can be grouped into one of the three functional divisions of the peripheral nervous system (PNS): sensory, motor and autonomic. One of the chemotherapeutic agents used in ALL is vincristine which has been associated with neuropathy in these children. This type of neuropathy can be transient but also leave permanent sequels that decrease patient's quality of life. Objectives: To know the frequency and type of neuropathy induced by chemotherapy in a subpopulation of Mexican pediatric patients with acute lymphoblastic leukemia. Methods: A cross-sectional study was conducted. There were included all pediatric patients with ALL diagnosed de novo from 2010 to December 31, 2013 who met the selection criteria. Descriptive statistics were used to determine the frequency and type of CIPN and information was described according to different clinical variables, type of treatment, risk classification, and ALL subtype according to the immunophenotype. Results: A total of 32 patients with acute lymphoblastic leukemia were included, mainly of early pre-B immunophenotype (93.8%), being 59.4% classified as high risk patients at the time of diagnosis. CIPN of sensory type was 78.1%, motor 34.3% and autonomic 40.6%. A significant proportion of patients (46.9%) were examined during maintenance phase. Conclusions: To our knowledge, this is the first study to report the frequency and type of CIPN in a subpopulation of Mexican children with acute lymphoblastic leukemia. Frequency of CIPN was higher than that reported in other populations. By considering that prognosis of a patient presenting CIPN could be considered as favorable after treatment suspension (in most cases), it is not always reversible and affects patient's quality of life. Therefore, it is necessary for all patients with ALL to be periodically monitored during treatment through neurological examination for detecting and immediately initiating their rehabilitation treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Chemotherapy-Induced Peripheral Neuropathy in a Subpopulation of Mexican Pediatric Patients with Acute Lymphoblastic Leukemia

et al. 2017

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“…Moreover, AML and MPAL seem to provide a worse prognosis of survival based on the time from NM to death. This information has been scarcely explored by other studies, and we suggest a potential effect from chemotherapy stages as well as subject-specific responses to treatments [ 36 , 37 , 38 , 39 ]. This is in accordance to the notion that patients with CNS infiltration retain a lower survival rate when compared to current success rates for AL therapy, mainly those with ALL, but MPAL may be underestimated [ 13 ].…”

Section: Discussionmentioning

confidence: 89%

Neurological Involvement in Pediatric Patients with Acute Leukemia: A Retrospective Cohort

et al. 2022

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Acute leukemia (AL) is an important cause of morbidity and mortality in children, and neurological manifestations (NM) are frequent. The objective of this study was to analyze neurological manifestations in children with acute leukemia from cases attended in the last five years at the Centro Médico Nacional “20 de Noviembre”. Methods: Conducting a retrospective and analytical study from 1 January 2015 to 31 December 2020 in children with AL classified according to sex, age range and AL type. Participants were grouped according the presence of NM. Results: We analyzed 607 patients: 54.85% boys and 44.14% girls, with a mean age of 7.27 ± 4.54 years. When comparing groups, the NM group was significantly older (p = 0.01), and the highest prevalence was between 6 and 12 years old. ALL was predominant over the other lineages (p ≤ 0.01). The most frequent NM was CNS infiltration, seizures, headache and neuropathy. Death outcomes occurred in 18.7% of children with AML, 11.8% with ALL and 50% with MPAL (p ≤ 0.002). The NM group was associated with higher mortality during a follow-up time of 77.9 ± 49 months (44.4% vs. 8.9% deaths, NM vs. non-NM, respectively; OR = 3.3; 95% CI 2.4 to 4.6; p ≤ 0.0001). Conclusions: ALL was the most prevalent leukemia type. CNS infiltration, seizures, headache, neuropathy and PRES were the most frequent symptoms in the NM group. NM was associated with a higher mortality rate.

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“…Methotrexate can cause disturbances in the metabolism of biopterins, serotonin, dopamine, homocysteine and sulfur-containing excitatory amino acids such as homocysteic acid (HCA) and cysteine-sulfi nic acid (CSA) in the CNS [5,18] . Steroids, L-asparaginase, antracyclines, cyclophosphamide and high doses of cytosine arabinoside may also penetrate through the blood-brain barrier and have anegative infl uence on CNS [3,6,21] .…”

Section: Discussion ▼mentioning

confidence: 99%

Cerebrospinal Fluid Changes in the Excitatory Amino Acids Concentration Caused by the Standard Treatment of Acute Lymphoblastic Leukaemia in Children do not Correlate with their Later Cognitive Functioning

Protas¹,

Muszyńska-Rosłan²,

Hołownia³

et al. 2009

Neuropediatrics

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The aim of this study was to ascertain whether changes in the concentrations of cerebrospinal fluid excitatory amino acids (EAAs) contribute to neurotoxicity of the standard acute lymphoblastic leukaemia (ALL) treatment protocols. We found a statistically significant increase in glutamate and aspartate in 12 ALL patients during their treatment. Cognitive functioning was examined in all patients at an average of 3.7 years after the disease diagnosis. Importantly, the levels of EAAs during the therapy were not correlated with the results of the cognitive test. This study suggests that standard ALL treatment-induced neurotoxicity may not lead to persistent neurocognitive deficits.

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Neurotoxicity of chemotherapeutic and biologic agents in children with cancer

Cited by 4 publications

References 54 publications

Chemotherapy-Induced Peripheral Neuropathy in a Subpopulation of Mexican Pediatric Patients with Acute Lymphoblastic Leukemia

Chemotherapy-Induced Peripheral Neuropathy in a Subpopulation of Mexican Pediatric Patients with Acute Lymphoblastic Leukemia

Neurological Involvement in Pediatric Patients with Acute Leukemia: A Retrospective Cohort

Cerebrospinal Fluid Changes in the Excitatory Amino Acids Concentration Caused by the Standard Treatment of Acute Lymphoblastic Leukaemia in Children do not Correlate with their Later Cognitive Functioning

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