Przeglad lekarski · 2003
[Electroneurophysiological and clinical consequences of therapy of acute lymphoblastic leukemia in children].
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Kroczka Sławomir, Kaciński Marek, Skoczeń Szymon, Balwierz Walentyna
Аннотация
INTRODUCTION: A common adverse effect of the treatment employed in acute lymphoblastic leukemia (ALL) is sensomotor polyneuropathy, the course of which is most frequently mild. The aim of the study was a clinical assessment of motor dexterity and sensory disturbances, as well as electroneurographic evaluation of sensory and motor fibers in the selected peripheral nerves and electromyographic assessment of patients after completed ALL treatment.
MATERIAL: The study included 30 patients aged 6-23 years (17 girls and 13 boys), in whom ALL treatment employing the New York or BFM protocols had been terminated 0.3-11 years earlier.
METHODS: Each patient was subjected to a neurological examination in the course of treatment and to a follow-up neurological assessment after therapy completion. Electro-neurography (ENG) and electromyography (EMG) were also performed in all subjects.
RESULTS: Clinical signs of polyneuropathy associated with chemotherapy were noted in 13 patients (43.3%) and in 11 subject (36.7%) in follow-up. Only three patients did not manifest any abnormal electro-neurophysiological signs. Electroneurographic and electromyographic abnormalities were more intense following the New York protocol in comparison to the BFM protocol and in the majority of patients were dependent on the cumulated vincristine dose.
CONCLUSIONS: Clinical signs of polyneuropathy were seen in 43.3% of children on chemotherapy for ALL and in 36.7% of subjects in follow-up. Ninety per cent of patients demonstrated abnormal electroneuro-physiological signs in consequence of ALL therapy. In all patients with abnormal EMG (63.3%) muscle reinnervation was detected.
MATERIAL: The study included 30 patients aged 6-23 years (17 girls and 13 boys), in whom ALL treatment employing the New York or BFM protocols had been terminated 0.3-11 years earlier.
METHODS: Each patient was subjected to a neurological examination in the course of treatment and to a follow-up neurological assessment after therapy completion. Electro-neurography (ENG) and electromyography (EMG) were also performed in all subjects.
RESULTS: Clinical signs of polyneuropathy associated with chemotherapy were noted in 13 patients (43.3%) and in 11 subject (36.7%) in follow-up. Only three patients did not manifest any abnormal electro-neurophysiological signs. Electroneurographic and electromyographic abnormalities were more intense following the New York protocol in comparison to the BFM protocol and in the majority of patients were dependent on the cumulated vincristine dose.
CONCLUSIONS: Clinical signs of polyneuropathy were seen in 43.3% of children on chemotherapy for ALL and in 36.7% of subjects in follow-up. Ninety per cent of patients demonstrated abnormal electroneuro-physiological signs in consequence of ALL therapy. In all patients with abnormal EMG (63.3%) muscle reinnervation was detected.