Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study

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Anastasopoulou , S , Heyman , M , Eriksson , M A , Niinimäki , R , Taskinen , M , Mikkel , S , Vaitkeviciene , G E , Johannsdottir , I M , Myrberg , I H , Jonsson , O G , Als-Nielsen , B , Schmiegelow , K , Banerjee , J , Ranta , S & Harila-Saari , A 2020 , ' Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study ' , European Journal of Paediatric Neurology , vol. 27 , pp. 72-77 . https://doi.org/10.1016/j.ejpn.2020.04.004

Title: Seizures during treatment of childhood acute lymphoblastic leukemia: A population-based cohort study
Author: Anastasopoulou, Stavroula; Heyman, Mats; Eriksson, Mats A.; Niinimäki, Riitta; Taskinen, Mervi; Mikkel, Sirje; Vaitkeviciene, Goda E.; Johannsdottir, Inga Maria; Myrberg, Ida Hed; Jonsson, Olafur Gisli; Als-Nielsen, Bodil; Schmiegelow, Kjeld; Banerjee, Joanna; Ranta, Susanna; Harila-Saari, Arja
Contributor organization: HUS Comprehensive Cancer Center
HUS Children and Adolescents
Lastentautien yksikkö
Children's Hospital
Hematologian yksikkö
Helsinki University Hospital Area
University of Helsinki
Date: 2020-07
Language: eng
Number of pages: 6
Belongs to series: European Journal of Paediatric Neurology
ISSN: 1090-3798
DOI: https://doi.org/10.1016/j.ejpn.2020.04.004
URI: http://hdl.handle.net/10138/329143
Abstract: Background Seizures are common in children with acute lymphoblastic leukemia (ALL). As ALL survival rates are improving, the challenge to minimize treatment related side effects and late sequelae rises. Here, we studied the frequency, timing, etiology and risk factors of seizures in ALL patients. Methods The study included children aged 1–17.9 years at diagnosis of B-cell-precursor and T cell ALL who were treated according to the Nordic Society of Pediatric Haematology and Oncology (NOPHO) ALL2008 protocol between 2008 and 2015. Detailed patient data were acquired from the NOPHO ALL2008 registry and by review of medical records. Results Seizures occurred in 81/1464 (5.5%) patients. The cumulative incidence of seizures at one months was 1.7% (95% CI: 1.2–2.5) and at one year 5.3% (95% CI 4.2–6.5%). Patients aged 10–17.9 years, those with T cell immunophenotype, CNS involvement, or high-risk induction with dexamethasone had higher risk for seizures in univariable analyses. Only age remained a risk factor in multivariable analyses (the cumulative incidence of seizures for patients 10–17.9 years old at one year was 9.0% (95% CI: 6.2–12.9)). Of the 81 patients with seizures, 43 had posterior reversible encephalopathy syndrome (PRES), 15 had isolated seizures, nine had sinus venous thrombosis (SVT), three had stroke-like syndrome, and 11 had other neurotoxicities. Epilepsy diagnosis was reported in totally 11 ALL survivors at last follow up. Conclusion Seizures are relatively common in ALL patients and occur most often in patients with PRES, SVT, or as an isolated symptom. Older children have higher risk of seizures.
Subject: Epilepsy
ALL
Neurotoxicity
METHOTREXATE-INDUCED NEUROTOXICITY
ITALIAN LEAGUE
RISK-FACTORS
GUIDELINES
ADULTS
REVERSIBLE ENCEPHALOPATHY SYNDROME
TOXICITY
CHILDREN
LEUKOENCEPHALOPATHY
ASPARAGINASE-ASSOCIATED PANCREATITIS
3112 Neurosciences
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: acceptedVersion


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