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Severe Permanent Encephalopathy in Acute Lymphoblastic Leukemia

Published online by Cambridge University Press:  18 September 2015

L. Maria Bernard ,
Dennis Maureen  and
Obonsawin Marc
L. Maria Bernard*
Affiliation:
Pediatric Neuro-Oncology Program (B.L.M.), Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida; the Department of Psychology (M.D., M.O.), The Hospital For Sick Children, University of Toronto
Dennis Maureen*
Affiliation:
Pediatric Neuro-Oncology Program (B.L.M.), Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida; the Department of Psychology (M.D., M.O.), The Hospital For Sick Children, University of Toronto
Obonsawin Marc*
Affiliation:
Pediatric Neuro-Oncology Program (B.L.M.), Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida; the Department of Psychology (M.D., M.O.), The Hospital For Sick Children, University of Toronto
*
University of Florida College of Medicine, Chief, Division of Pediatric Neurology, Box J-296, J.H.M. Health Center, Gainesville, Florida, USA 32610
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Abstract:

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As survival rates for childhood acute lymphoblastic leukemia have increased, concerns over improved quality-of-life have also increased. Although 3-10% of children may experience acute transient neurotoxicity during induction chemotherapy, they are felt to be at low risk for late sequelae. We report three previously healthy boys with newly-diagnosed acute lymphoblastic leukemia who presented with obtundation and severe seizures during late induction with a standard four drug chemotherapy regimen. While all three are disease-free survivors, they unexpectedly have persistent and medically intractable partial complex seizures, broad-based neuropsychological impairment and striking neuroimaging abnormalities. These findings suggest that children with leukemia who develop an acute encephalopathy during induction chemotherapy are at risk for long-term neurological and neuropsychological sequelae, despite the cessation of further potentially neurotoxic therapy.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 20 , Issue 3 , August 1993 , pp. 199 - 205
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

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