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

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

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).

TidsskriftPediatric Blood and Cancer
Udgave nummer7
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This study was supported by grants provided by the Swedish Childhood Cancer Fund, Sweden. We would like to thank Ida Hed Myrberg for her statistical advice.

Publisher Copyright:
© 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.

ID: 310435375