Children (Aug 2022)

Neurological Involvement in Pediatric Patients with Acute Leukemia: A Retrospective Cohort

  • Diana Alejandra Cruz-Chávez,
  • Brian Javier López-Pérez,
  • Elsa Solórzano-Gómez,
  • José Antonio Venta-Sobero,
  • Luz Victoria Flores-Villegas,
  • Christian Gabriel Toledo-Lozano,
  • Gabriela Vianney Castro-Loza,
  • Roberto Sandoval-Pacheco,
  • Andrea Torres-Vallejo,
  • Karen Sharlot Faisury Marmol-Realpe,
  • Yazmín Evelyn Flores-Jurado,
  • Cristal Lucero Hernández-Soriano,
  • Sofía Lizeth Alcaraz-Estrada,
  • Paul Mondragón-Terán,
  • Juan Antonio Suárez-Cuenca,
  • Ramón Mauricio Coral-Vázquez,
  • Silvia Garcia

DOI
https://doi.org/10.3390/children9091268
Journal volume & issue
Vol. 9, no. 9
p. 1268

Abstract

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Acute leukemia (AL) is an important cause of morbidity and mortality in children, and neurological manifestations (NM) are frequent. The objective of this study was to analyze neurological manifestations in children with acute leukemia from cases attended in the last five years at the Centro Médico Nacional “20 de Noviembre”. Methods: Conducting a retrospective and analytical study from 1 January 2015 to 31 December 2020 in children with AL classified according to sex, age range and AL type. Participants were grouped according the presence of NM. Results: We analyzed 607 patients: 54.85% boys and 44.14% girls, with a mean age of 7.27 ± 4.54 years. When comparing groups, the NM group was significantly older (p = 0.01), and the highest prevalence was between 6 and 12 years old. ALL was predominant over the other lineages (p ≤ 0.01). The most frequent NM was CNS infiltration, seizures, headache and neuropathy. Death outcomes occurred in 18.7% of children with AML, 11.8% with ALL and 50% with MPAL (p ≤ 0.002). The NM group was associated with higher mortality during a follow-up time of 77.9 ± 49 months (44.4% vs. 8.9% deaths, NM vs. non-NM, respectively; OR = 3.3; 95% CI 2.4 to 4.6; p ≤ 0.0001). Conclusions: ALL was the most prevalent leukemia type. CNS infiltration, seizures, headache, neuropathy and PRES were the most frequent symptoms in the NM group. NM was associated with a higher mortality rate.

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