Central Nervous System Complications in Children Receiving Chemotherapy or Hematopoietic Stem Cell Transplantation

Cordelli, Duccio Maria; Masetti, Riccardo; Zama, Daniele; Toni, Francesco; Castelli, Ilaria; Ricci, Emilia; Franzoni, Emilio; Pession, Andrea

doi:10.3389/fped.2017.00105

Cited by 20 publications

(22 citation statements)

References 125 publications

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“…As previously reported, the posterior reversible encephalopathy syndrome is the most frequent central nervous system complication in children treated for cancer, 9 -12 and in our study it represented 64% of all events. We observed a high diagnostic accuracy of the CT in recognizing the posterior reversible encephalopathy syndrome: the CT correctly suggested diagnosis in 76% (16/21) of the posterior reversible encephalopathy syndrome cases (12/16 transplanted patients and 4/5 nontransplanted patients, respectively 75% and 80%).…”

Section: Discussionsupporting

confidence: 84%

Computed Tomography in Acute Severe Central Nervous System Complications in Children Treated for Cancer: Still a Useful Diagnostic Tool in the Emergency Setting

et al. 2020

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We retrospectively checked patients who underwent chemotherapy and/or hematopoietic stem cell transplantation from 2007 to 2016, in order to evaluate whether early computed tomography is useful in children treated for cancer with acute central nervous system complications. Out of a total sample of 443 patients, 52 children (11.7%) presented these complications. In the end, 31 patients were included, with a total of 33 events of central nervous system complications. The computed tomography was abnormal in 22 events (67%) and diagnostic for a specific complication in 20 events (61%), whereas it directly influenced the treatment in 16 events (48%). Computed tomography should be still considered a relevant diagnostic tool in the management of acute central nervous system complications in the emergency setting.

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Section: Discussionsupporting

confidence: 84%

Computed Tomography in Acute Severe Central Nervous System Complications in Children Treated for Cancer: Still a Useful Diagnostic Tool in the Emergency Setting

et al. 2020

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“…In this review, we have provided a comprehensive review of both the acute and long-term neurological complications in children following HSCT for ALL. The majority of the literature on acute neurotoxicity is in the adult population, although some studies included children and a minority of studies focussed on paediatric HSCT recipients ( 1 – 6 , 104 , 233 , 234 ). Within these studies, the paediatric populations were heterogeneous, with children undergoing HSCT for a variety of indications and use of different stem cell sources and a range of conditioning regimens.…”

Section: Discussionmentioning

confidence: 99%

A Review of Acute and Long-Term Neurological Complications Following Haematopoietic Stem Cell Transplant for Paediatric Acute Lymphoblastic Leukaemia

et al. 2021

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Despite advances in haematopoietic stem cell transplant (HSCT) techniques, the risk of serious side effects and complications still exists. Neurological complications, both acute and long term, are common following HSCT and contribute to significant morbidity and mortality. The aetiology of neurotoxicity includes infections and a wide variety of non-infectious causes such as drug toxicities, metabolic abnormalities, irradiation, vascular and immunologic events and the leukaemia itself. The majority of the literature on this subject is focussed on adults. The impact of the combination of neurotoxic drugs given before and during HSCT, radiotherapy and neurological complications on the developing and vulnerable paediatric and adolescent brain remains unclear. Moreover, the age-related sensitivity of the nervous system to toxic insults is still being investigated. In this article, we review current evidence regarding neurotoxicity following HSCT for acute lymphoblastic leukaemia in childhood. We focus on acute and long-term impacts. Understanding the aetiology and long-term sequelae of neurological complications in children is particularly important in the current era of immunotherapy for acute lymphoblastic leukaemia (such as chimeric antigen receptor T cells and bi-specific T-cell engager antibodies), which have well-known and common neurological side effects and may represent a future treatment modality for at least a fraction of HSCT-recipients.

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“…For example, chemotherapy-related complications on gastrointestinal tract ( Boussios et al, 2012 ) and cardiovascular toxicities ( Swain et al, 2003 ; Jones et al, 2007 ; Khouri et al, 2012 ) have already been reported. Furthermore, chemotherapy related toxicities on the central nervous system (e.g., methotrexate) ( Cordelli et al, 2017 ) and cardiomyopathy (e.g., doxorubicin) have also been reported ( Chatterjee et al, 2010 ). Besides toxicities, the undesirable effect of some therapeutics (e.g., tamoxifen) involves impact on patient’s face, eyelids, and eyebrows, resulting in frequent visits to the optometrist as well ( Omoti and Omoti, 2006 ).…”

Section: Opportunities Challenges and Future Directionsmentioning

confidence: 99%

Is There an Opportunity for Current Chemotherapeutics to Up-regulate MIC-A/B Ligands?

Quirk

Ganapathy-Kanniappan

2017

Front. Pharmacol.

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Natural killer (NK) cells are critical effectors of the immune system. NK cells recognize unhealthy cells by specific ligands [e.g., MHC- class I chain related protein A or B (MIC-A/B)] for further elimination by cytotoxicity. Paradoxically, cancer cells down-regulate MIC-A/B and evade NK cell’s anticancer activity. Recent data indicate that cellular-stress induces MIC-A/B, leading to enhanced sensitivity of cancer cells to NK cell-mediated cytotoxicity. In this Perspective article, we hypothesize that current chemotherapeutics at sub-lethal, non-toxic dose may promote cellular-stress and up-regulate the expression of MIC-A/B ligands to augment cancer’s sensitivity to NK cell-mediated cytotoxicity. Preliminary data from two human breast cancer cell lines, MDA-MB-231 and T47D treated with clinically relevant therapeutics such as doxorubicin, paclitaxel and methotrexate support the hypothesis. The goal of this Perspective is to underscore the prospects of current chemotherapeutics in NK cell immunotherapy, and discuss potential challenges and opportunities to improve cancer therapy.

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Central Nervous System Complications in Children Receiving Chemotherapy or Hematopoietic Stem Cell Transplantation

Cited by 20 publications

References 125 publications

Computed Tomography in Acute Severe Central Nervous System Complications in Children Treated for Cancer: Still a Useful Diagnostic Tool in the Emergency Setting

Computed Tomography in Acute Severe Central Nervous System Complications in Children Treated for Cancer: Still a Useful Diagnostic Tool in the Emergency Setting

A Review of Acute and Long-Term Neurological Complications Following Haematopoietic Stem Cell Transplant for Paediatric Acute Lymphoblastic Leukaemia

Is There an Opportunity for Current Chemotherapeutics to Up-regulate MIC-A/B Ligands?

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