Document Detail


CNS complications in children receiving chemotherapy or hematopoietic stem cell transplantation: retrospective analysis and clinical study of survivors.
MedLine Citation:
PMID:  17455315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical studies analyzing CNS complications in pediatric oncology systematically are rare. PROCEDURE: In a single center retrospective analysis, CNS complications in 950 subsequent pediatric patients treated between 1992 and 2004 by chemotherapy or hematopoietic stem cell transplantation (HSCT) were studied. Forty-six patients had pre-existing CNS diseases and were excluded. Out of the 904 remaining, 76 (8.4%) had 82 CNS complications. RESULTS: The most common manifestations were seizures (in 50.6% of the CNS episodes), altered states of consciousness, and motor deficits (in 47.5% of the episodes each). CNS complications were caused by infections (26.8%), toxicity (25.6%), neoplasma (13.4%), vascular (10.9%), and metabolic disturbances (8.5%). In 14.6%, the mechanism remained unclear. Patients (23.7%) died from the CNS event. Neoplastic disorders had the worst (50%) while metabolic the best (0% mortality) prognosis. Imaging techniques were the most effective diagnostic measures, followed by laboratory analysis, clinical examination, and CSF analysis. A neuro-psychological (CBCL, CFT-1/-20-testing) examination could be done in 21 of 32 long-term survivors. Seven had a major, 3 minor neurological impairment, 11 were normal in all tests. CONCLUSIONS: These data show that there is not one typical CNS complication, but a wide variety. There is no close connection between either underlying disease or symptoms and cause of the complication. Prognosis is variable. About two thirds of the long-term survivors could lead a normal life.
Authors:
Katrin Schmidt; Ansgar Stephan Schulz; Klaus-Michael Debatin; Wilhelm Friedrich; Carl Friedrich Classen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  50     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2007-12-12     Completed Date:  2008-01-10     Revised Date:  2009-01-12    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
Affiliation:
University Children's Hospital Ulm, Eythstr. 24, D-89081 Ulm, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Central Nervous System Diseases / chemically induced,  etiology*,  psychology
Child
Child, Preschool
Female
Hematologic Diseases / complications,  drug therapy,  psychology,  surgery,  therapy*
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Infant
Male
Neoplasms / drug therapy,  psychology,  surgery,  therapy*
Retrospective Studies

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