Does minimal central nervous system involvement in childhood acute lymphoblastic leukemia increase the risk for central nervous system toxicity?

Stavroula Anastasopoulou, Arja Harila-Saari, Bodil Als-Nielsen, Mats Anders Eriksson, Mats Heyman, Inga Maria Johannsdottir, Hanne Vibeke Marquart, Riitta Niinimäki, Cornelis Jan Pronk, Kjeld Schmiegelow, Goda Vaitkeviciene, Maria Thastrup, Susanna Ranta

1 Citation (Scopus)

Abstract

Central nervous system (CNS) involvement in childhood acute lymphoblastic leukemia (ALL) implicates enhanced intrathecal chemotherapy, which is related to CNS toxicity. Whether CNS involvement alone contributes to CNS toxicity remains unclear. We studied the occurrence of all CNS toxicities, seizures, and posterior reversible encephalopathy syndrome (PRES) in children with ALL without enhanced intrathecal chemotherapy with CNS involvement (n = 64) or without CNS involvement (n = 256) by flow cytometry. CNS involvement increased the risk for all CNS toxicities, seizures, and PRES in univariate analysis and, after adjusting for induction therapy, for seizures (hazard ratio [HR] = 3.33; 95% confidence interval [CI]: 1.26-8.82; p = 0.016) and PRES (HR = 4.85; 95% CI: 1.71-13.75; p = 0.003).

Original languageEnglish
Article numbere29745
JournalPediatric Blood & Cancer
Volume69
Issue number7
Pages (from-to)e29745
ISSN1545-5009
DOIs
Publication statusPublished - Jul 2022

Keywords

  • CNS leukemia
  • CNS toxicity
  • flow cytometric immunophenotyping
  • pediatric acute lymphoblastic leukemia

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