Noha abd elshafy elsaid
National Cancer Institute Cairo University Egypt.
Title: POSTCHEMOTHERAPY BRAIN CHANGES IN CHILDHOOD LEUKEMIA, EVALUATION BY MRI
Biography
Biography: Noha abd elshafy elsaid
Abstract
Leukemia is the most common pediatric malignancy. Acute lymphoblastic leukemia accounts for about one-fourth of all childhood cancers and about 75% of all childhood leukemias. Recent advances in therapy such as aggressive polychemotherapy, intrathecal cytostatic prophylaxis for pediatric leukemia have greatly improved the prognosis but have resulted in an increased incidence of associated complications and toxic effects. The main neuro-imaging features in pediatric patients with leukemia treated with chemotherapy were prospectively studied. Aim of the study: is to evaluate the role of MRI in the detection of the side effects of chemotherapy on the brain in leukemic children presenting with clinical symptoms. Patients and methods: 20 pediatric patients their age range 1-16 years receiving or have received chemotherapy for acute leukemia have undergone MR examination of the brain for evaluation of neurological symptoms related to treatment from August to December 2015. Results: This study included 20 children, 15 (75%) were male and 5 (25%) were female. Their ages at the time of the study ranged from 1-16 years. 17 patients (85%) were on maintenance chemotherapy, 2 patients (10%) were on induction and 1 patient (5%) had finished treatment. Multiple complications were recorded by MRI and its correlation to the treatment phase of the cases. All cases of Sino-venous thrombosis & hemorrhage occurred within the maintenance phase. Leuco-encephalopathy was divided equally between maintenance & induction phases.Brain atrophy was divided equally between induction & maintenance phases. PRES occurred within the maintenance phase. Most of infection cases (sinusitis & otitis media) occurred within maintenance; only one case was seen in a patient who just ended his chemotherapy. Conclusion: Chemotherapy is associated with certain side effects that can be evaluated by utilization of MRI. An elevated degree of suspicion is needed to recognize the radiologic features of CNS complications of chemotherapy and familiarity with the imaging findings is essential for proper diagnosis and further treatment of neurologic symptoms in pediatric patients with leukemia.