Does minimal central nervous system involvement in childhood acute lymphoblastic leukemia increase the risk for central nervous system toxicity?
Anastasopoulou, Stavroula; Harila-Saari, Arja; Als-Nielsen, Bodil; Eriksson, Mats Anders; Heyman, Mats; Johannsdottir, Inga Maria; Marquart, Hanne Vibeke; Niinimäki, Riitta; Pronk, Cornelis Jan; Schmiegelow, Kjeld; Vaitkeviciene, Goda; Thastrup, Maria; Ranta, Susanna (2022-04-30)
Anastasopoulou, S., Harila‐Saari, A., Als‐Nielsen, B., Eriksson, M. A., Heyman, M., Johannsdottir, I. M., Marquart, H. V., Niinimäki, R., Pronk, C. J., Schmiegelow, K., Vaitkeviciene, G., Thastrup, M., & Ranta, S. (2022). Does minimal central nervous system involvement in childhood acute lymphoblastic leukemia increase the risk for central nervous system toxicity? Pediatric Blood & Cancer, 69(7). https://doi.org/10.1002/pbc.29745
© 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
https://creativecommons.org/licenses/by-nc-nd/4.0/
https://urn.fi/URN:NBN:fi-fe2022123074131
Tiivistelmä
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).
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