Acute and Long-term Neurological Complications of Acute Lymphoblastic Leukemia (ALL) Therapy in Latino Children

Abstract

Over the last several decades, the survival for pediatric acute lymphoblastic leukemia (ALL) has increased from about 40–90%. However, current treatment strategies are associated with several acute and long-term toxicities, including neurotoxicity. Further, racial and ethnic disparities persist in both incidence and outcomes for ALL. In particular, Latino children experience both the highest incidence of ALL and less favorable outcomes. The incidence of neurotoxicity during ALL therapy potentially jeopardizes treatment efficacy, and long-term neurocognitive impairment profoundly affects quality of life for survivors. Emerging evidence indicates that Latino patients may be particularly susceptible to these adverse side effects of therapy. Unfortunately, studies of neurotoxicity during ALL therapy have not included large populations of Latino children. Therefore, well-designed studies are needed to characterize neurotoxicity outcomes in Latino patients, while considering factors associated with disparities in cognitive performance in the general population, including socioeconomic status and acculturation. Ultimately, a better understanding of the various factors likely responsible for disparities in neurotoxicity is needed to improve outcomes for Latino children with ALL; these factors include inherited genetic variation, clinical characteristics, and sociocultural differences.