The article presents an assessment of the neurotoxicity of chemotherapy in children with acute lymphoblastic leukemia receiving specific treatment according to the protocols used in pediatric oncological practice. An analysis of the neurological state with the determination of the chemokine profile of blood plasma was performed in 21 children aged 3 to 17 at the Regional Children’s Clinical Hospital in Yekaterinburg and the Central Research Laboratory of the Ural State Medical University in 2019. In the study group of children, neurotoxic complications were recorded in 42.9% of cases. At the same time, the appearance of neurological symptoms in most patients (77.7%) was observed during co chemotherapy at the stages of reinduction during consolidating treatment with a predominant clinical picture of chemo-induced polyneuropathy. In a comparative analysis of the indicators of the chemokine profile in groups of children, depending on the formation of neurotoxic complications during chemotherapy, we selected the chemokines CXCL10 (IP-10) and CXCL12 (SDF-1α) as possible prognostic biomarkers of damage to the nervous system.

In some cases standard chemotherapy of acute lymphocytic leukemia (ALL) leads to neurotoxicity; its mechanisms, methods of prognosis, and prevention are being actively studied. The aim of this study was to assess the cytokine profile in cerebrospinal fluid (CSF) of children with ALL and neurotoxic side effects of chemotherapy. This prospective study included 24 children with ALL aged from 3 to 17 years. Patients were further subdivided into ALL patients with (main group) and without neurological complications (comparison group). The level of cytokines in CSF was measured by Xmap technology (Luminex) using Invitrogen test systems (eBioscience) and the Luminex 200 system. The comparative analysis of the cytokine profile in the group of children with chemotherapy-induced neurotoxic complications revealed elevated levels of chemokine CXCL12 (SDF-1α) and stem cell factor (SCF). Increased level of these cytokines in CSF was characterized by a relatively risk for development of toxic peripheral neuropathy.

The prevalence of cognitive impairment in patients with multiple sclerosis is 40 to 65%. Improvement of cognitive-oriented therapy and search for its new techniques is considered to be promising for slowing the progression or for recovery of cognitive functions. It is related to low efficacy of medical treatment, preserved neuroplasticity in most patients with multiple sclerosis, positive results of studies on selected cognitive rehabilitation techniques in other nervous system disorders. The spectrum of techniques for cognitive training varies from technically feasible methods using a sheet of paper and a pen to the most advanced ones, such as the use of immersive virtual reality. The effectiveness of cognitive rehabilitation in patients with multiple sclerosis with virtual reality technologies has not been studied in large-scale randomized placebo-controlled studies.

Содержание курса раскрывает спектр современных знаний по проблемам нейроонкологической патологии у детей. Рассматриваются такие вопросы как: эпидемиологическая характеристика и принципы классификации опухолей неврной системыу детей, особенности клинических проявлений в зависимости от локализации опухолевого процесса и возраста ребенка, опухолевые факоматозы, структурные формы эпилепсии при объемных образованиях головного мозга, вопросы нейротоксических осложнений химиотерапии у детей. Порядки и стандарты оказания медицинской помощи , наблюдение, пациентов детского возраста с нейроонкологической патологией на амбулаторном этапе после нейрохирургического лечения, важные аспекты паллиативной помощи детям с нейроонкологической патологией.