Magnetic resonance imaging of changes in the brain of children cured of acute lymphoblastic leukemia

• Published in: Hematology reports Vol. 11; no. 3; p. 7946
• Main Authors: Bondarenko, Vladislav P., Tereschenko, Galina V., Andrianov, Mikhail M., Rumyantseva, Yulia V., Karachunsky, Alexander I., Kasatkin, Vladimir N., Karelin, Alexander F., Anisimov, Viktor N., Zhukovskaya, Elena V., Rumyantsev, Alexander G.
• Format: Journal Article
• Language: English; Italian
• Published: Pavia MDPI AG 18.09.2019; PAGEPress Scientific Publications, Pavia, Italy; PAGEPress Publications, Pavia, Italy
• Subjects: Acute lymphoblastic leukemia; Brain injury; Central nervous system; Chemotherapy; Children; Cognition; Cognitive ability; Leukemia; Leukoencephalopathy; Lymphatic leukemia; Magnetic resonance imaging; Neuroimaging; Neurotoxicity; Patients; Prevention; Radiation therapy; rehabilitation
• ISSN: 2038-8322; 2038-8330
• DOI: 10.4081/hr.2019.7946

This study was aimed to systematize magnetic resonance imaging (MRI) presentation of toxic leukoencephalopathy, to find the correlation between method of central nervous system (CNS) leukemia prevention and changes on MRI, to find relationship between existence leukoencephalopathy on imaging and neurocognitive deficits in pediatric patients after anti-leukemic therapy. Brain MRI data of 48 children, who underwent a therapy course according to the ALL-MB intermediate risk protocol, was evaluated. In accordance with two arms of this protocol, they received either radiation therapy, or additional intrathecal administration of chemotherapeutic agents as a prevention of CNS leukemia. Also, neurocognitive tests were performed. According to the results of the performed investigation, 10 (50%) out of 20 children, who received cranial irradiation and 18 (66.6%) out of 27 patients, who received only intrathecal therapy demonstrated abnormal brain changes (leukoencephalopathy) according to MRI data. Leukoencephalopathy was mostly presented by diffuse zones and localized predominantly in the frontal and temporal lobes. There was no correlation between method of CNS prevention and the existence of leukoencephalopathy on MRI. The analysis of our data did not show significant differences in brain damage and severity of cognitive impairment depending on the type of prevention of CNS leukemia. Moreover, in this study no statistical correlation was found between leukoencephalopathy on MRI and neurocognitive impairment according to clinical tests data. Further long-term prospective studies and examinations should be performed to assess late neurotoxic effects.