Stroke-like leukopathy in children with acute lymphoblastic leukemia
https://doi.org/10.21682/2311-1267-2021-8-1-14-22
Abstract
There are considerable variations in the reported incidence methotrexate-induced neurotoxicity in children with malignancies. The etiology of acute neurological deficit in pediatric patients with malignancies during polychemotherapy can be diverse: cerebrovascular disease (arterial ischemic stroke, intracranial hemorrhage, venous sinus thrombosis, or their combination), stroke-like migraine attacks after radiation therapy (SMART), posterior reversible encephalopathy syndrome (PRES), thrombotic microangiopathy, toxic leukoencephalopathy (include strokelike leukoencephalopathy). The tactics of a neurologist largely depends on the reasons that caused the neurological deficit. The doctor needs knowledge not only of the clinical picture and the characteristics of the course of the underlying disease, but also of possible complications arising both as a result of the disease itself and due to the therapy being carried out. Timely diagnosis and correct interpretation of emerging neurological events make it possible to determine rational accompanying therapy. The article presents case histories of children with acute lymphoblastic leukemias and acute neurological deficits, with an analysis of their possible causes.
About the Authors
N. V. Natrusova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow;
N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
Neurologist Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow, Neurologist,
1/9 4th Dobryninskiy Per., Moscow, 119049;
23 Kashirskoe Shosse, Moscow, 115478
I. O. Shchederkina
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Neurologist, Head of the Center for the Treatment of Cerebrovascular Diseases in Children and Adolescents,
1/9 4th Dobryninskiy Per., Moscow, 119049
E. V. Seliverstova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Radiologist,
1/9 4th Dobryninskiy Per., Moscow, 119049
O. A. Tiganova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
1/9 4th Dobryninskiy Per., Moscow, 119049
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Chief External Oncologist at the Department of Health in Moscow, Hematologist-oncologist, 1/9 4th Dobryninskiy Per., Moscow, 119049;
Associate Professor Department of Pediatrics, 1 Ostrovityanova St., Moscow, 117997
K. L. Kondratchik
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow;
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Head of the Center for Pediatric Oncology and Hematology, Head of the Department of Oncology and Hematology, 1/9 4th Dobryninskiy Per., Moscow, 119049;
Associate Professor Department of Oncology, Hematology and Immunology, 1 Ostrovityanova St., Moscow, 117997
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Review
For citations:
Natrusova N.V., Shchederkina I.O., Seliverstova E.V., Tiganova O.A., Kondratchik K.L. Stroke-like leukopathy in children with acute lymphoblastic leukemia. Russian Journal of Pediatric Hematology and Oncology. 2021;8(1):14-22. (In Russ.) https://doi.org/10.21682/2311-1267-2021-8-1-14-22
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