Clinical Characteristics and Long-Term Follow-Up of Leukoencephalopathy in Pediatric Acute Lymphoblastic Leukemia After Chemotherapy.

IF 2.6 4区医学 Q3 ONCOLOGY

Cancer Management and Research Pub Date : 2026-09-16 eCollection Date: 2026-01-01 DOI:10.2147/CMAR.S631566

Jun Feng, Xiao Xiao, Jihong Tang, Bingbing Zhang

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Abstract

Purpose: This study aimed to investigate the clinical characteristics and long-term outcomes of leukoencephalopathy (LE) in pediatric patients with acute lymphoblastic leukemia (ALL) after chemotherapy, with the goal of evaluating diagnosis, treatment, and prognosis.

Methods: We retrospectively analyzed the clinical data of 48 pediatric ALL patients diagnosed with LE after chemotherapy at the Children's Hospital of Soochow University (February 2010-December 2024). Data included general information, Clinical manifestations and diagnostic imaging results. Compared with a control group of 27 healthy children, the patients' cognitive function was assessed by using the Behavioural Rating Inventory of Executive Function-2 (BRIEF-2) and the Wechsler Intelligence Scale for Children (WISC).

Results: Neurological symptoms were observed in 47.92% (23/48) of LE patients, including seizures (27.08%), paralysis (12.50%), limb numbness (10.42%), and speech impairment (10.42%). Brain MRI revealed white matter abnormalities, predominantly in the periventricular regions (47.92%), parietal lobes (37.50%), and frontal lobes (22.92%). Long-term follow-up demonstrated that 73.91% of symptomatic patients experienced rapid neurological improvement, and 83.33% of cases showed a significant reduction in MRI lesions within 12 months. Compared to controls, patients with LE exhibited higher BRIEF-2 scores (indicating executive dysfunction) for self-monitoring, emotional control, working memory, and planning/organization (all P < 0.05). The WISC scores were significantly lower for the total IQ, perceptual reasoning, working memory, and processing speed (P < 0.05).

Conclusion: Post-chemotherapy LE in pediatric ALL presents with diverse neurological symptoms and neuroimaging abnormalities accompanied by mild-to-moderate cognitive deficits. However, the prognosis appears favorable, with most patients showing symptom resolution and improved imaging findings.

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小儿急性淋巴细胞白血病化疗后白质脑病的临床特点及长期随访。

目的：本研究旨在探讨急性淋巴细胞白血病（ALL）患儿化疗后白质脑病（LE）的临床特点及远期预后，以评价其诊断、治疗及预后。方法：回顾性分析2010年2月- 2024年12月苏州大学儿童医院48例化疗后诊断为LE的儿童ALL患者的临床资料。资料包括一般资料、临床表现和诊断影像结果。采用执行功能行为评定量表（BRIEF-2）和韦氏儿童智力量表（WISC）对患儿的认知功能进行评估，并与对照组27例健康儿童进行比较。结果：47.92%（23/48）的LE患者出现神经系统症状，包括癫痫发作（27.08%）、瘫痪（12.50%）、肢体麻木（10.42%）和语言障碍（10.42%）。脑MRI显示白质异常，主要在脑室周围区域（47.92%）、顶叶（37.50%）和额叶（22.92%）。长期随访显示，73.91%有症状的患者神经系统快速改善，83.33%的病例在12个月内MRI病变明显减少。与对照组相比，LE患者在自我监控、情绪控制、工作记忆和计划/组织方面表现出更高的BRIEF-2评分（表明执行功能障碍）（均P < 0.05）。总智商、知觉推理、工作记忆和加工速度的WISC得分显著低于对照组（P < 0.05）。结论：小儿ALL化疗后LE表现为多种神经系统症状和神经影像学异常，并伴有轻度至中度认知障碍。然而，预后良好，大多数患者表现出症状缓解和影像学改善。

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.