Neurotoxicidad asociada al tratamiento de niños y adolescentes con Leucemia Linfoblástica Aguda
Neurotoxicity associated with the treatment of children and adolescents with acute lymphoblastic leukemia
Palabras clave:
Síndrome de Leucoencefalopatía Posterior, Leucemia en niños, Trombosis del seno venoso, NeurotoxicidadResumen
La neurotoxicidad secundaria al tratamiento quimioterápico en pacientes pediátricos con diagnóstico de Leucemia Linfoblástica Aguda es relativamente frecuente. Debido a ello es que, ante un cuadro clínico neurológico en estos pacientes, es fundamental considerarlo y solicitar los estudios complementarios adecuados para confirmar o descartar este diagnóstico diferencial. Se presenta en este trabajo una revisión bibliográfica mediante casos clínicos sobre este tema.
Citas
Inaba H, Mullighan CG. Pediatric acute lymphoblastic leukemia. Haematologica. 2020;105(11): 2524–2539.
Bhojwani D, Bansal R, Wayne AS. Managing therapy-associated neurotoxicity in children with ALL. Hematology Am Soc Hematol Educ Program. 2021;2021(1): 376–383.
Śliwa-Tytko P, Kaczmarska A, Lejman M, et. Al. Neurotoxicity Associated with Treatment of Acute Lymphoblastic Leukemia Chemotherapy and Immunotherapy. Int J Mol Sci. 2022;23(10): 5515.
Anastasopoulou S, Nielsen RL, Als-Nielsen B, et al. Acute central nervous system toxicity during treatment of pediatric acute lymphoblastic leukemia: phenotypes, risk factors and genotypes. Haematologica. 2022;107(10): 2318–2328.
Banerjee JS, Heyman M, Palomäki M, et al. Posterior reversible encephalopathy syndrome: Risk factors and impact on the outcome in children with acute lymphoblastic leukemia treated with Nordic protocols. J Pediatr Hematol Oncol. 2018;40(1): e13–e18.
Anastasopoulou S, Eriksson MA, Heyman M, et al. Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia: Clinical characteristics, risk factors, course, and outcome of disease. Pediatr Blood Cancer. 2019;66(5): e27594.
Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiologi-cal manifestations, pathophysiology, and outstanding questions. Lancet Neurol. 2015;14(9): 914–925. Epub 2015 Jul 13.
Schmiegelow K, Attarbaschi A, Barzilai S, et al. Consensus definitions of 14 severe acute toxic ef-fects for childhood lymphoblastic leukaemia treatment: a Delphi consensus. Lancet Oncol. 2016;17(6): e231–e239.
Granata G, Greco A, Iannella G, et al. Posterior reversible encephalopathy syndrome--Insight in-to pathogenesis, clinical variants and treatment approaches. Autoimmun Rev. 2015;14(9): 830–836. Epub 2015 May 18.
Mateos MK, Marshall GM, Barbaro PM, et al. Methotrexate-related central neurotoxicity: clinical characteristics, risk factors and genome-wide association study in children treated for acute lymphoblastic leukemia. Haematologica. 2022;107(3): 635–643.
El-Khoury H, Saifi O, Haddad S, et al. Treatment-induced cerebral sinus venous thrombosis in childhood acute lymphoblastic malignancies: New risk factors to consider. Pediatr Blood Cancer. 2021;68(11): e29210. Epub 2021 Jul 29.
Musgrave KM, van Delft FW, Avery PJ, et al. Cerebral sinovenous thrombosis in children and young adults with acute lymphoblastic leukaemia - a cohort study from the United Kingdom. Br J Haematol. 2017;179(4): 667–669. Epub 2016 Jul 8.
Ranta S, Tuckuviene R, Mäkipernaa A, et al. Cerebral sinus venous thromboses in children with acute lymphoblastic leukaemia - a multicentre study from the Nordic Society of Paediatric Hae-matology and Oncology. Br J Haematol. 2015;168(4): 547–552. Epub 2014 Oct 7.
Ghanem KM, Dhayni RM, Al-Aridi C, et al. Cerebral sinus venous thrombosis during childhood acute lymphoblastic leukemia therapy: Risk factors and management. Pediatr Blood Cancer. 2017;64(12): e26694.
Qureshi A, Mitchell C, Richards S, Vora A, et al. Asparaginase-related venous thrombosis in UKALL 2003- re-exposure to asparaginase is feasible and safe. Br J Haematol. 2010;149(3): 410–413. Epub 2010 Mar 10.
Quinn CT, Griener JC, Bottiglieri T, et al. Elevation of homocysteine and excitatory amino acid neurotransmitters in the CSF of children who receive methotrexate for the treatment of cancer. J Clin Oncol. 1997;15(8): 2800–2806.
Watanabe K, Arakawa Y, Oguma E, et al. Characteristics of methotrexate-induced stroke-like neurotoxicity. Int J Hematol. 2018;108(6): 630–636.
Bond J, Hough R, Moppett J, et al. “Stroke-like syndrome” caused by intrathecal methotrexate in patients treated during the UKALL 2003 trial. Leukemia. 2013;27(4): 954–956.
Bhojwani D, Sabin ND, Pei D, et al. Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. J Clin Oncol. 2014;32(9): 949–959.
Drachtman RA, Cole PD, Golden CB, et al. Dextromethorphan is effective in the treatment of subacute methotrexate neurotoxicity. Pediatr Hematol Oncol. 2002;19(5): 319–327.
Publicado
Número
Sección
Licencia
Derechos de autor 2025 Revista del Hospital de Niños de Buenos Aires
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Todo el contenido que se publica en la Revista del Hospital de Niños de Buenos Aires está bajo una Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional (CC-BY-NC-ND 4.0)
