All issues > Volume 46(11); 2003

Original Article

J Korean Pediatr Soc. 2003;46(11):1112-1117. Published online November 15, 2003.

CNS Complications in Childhood Cancer

Yoo Jin YJ Jeong¹, Yeon Kyong YK Seo¹, Seung Ah SA Hong¹, Heung Sik HS Kim¹, Jun Sik JS Kim¹, Hee Jung HJ Lee²

¹Department of Pediatrics, School of Medicine, Keimyung University, Taegu, Korea
²Department of Diagnostic Radiology, School of Medicine, Keimyung University, Taegu, Korea

Correspondence Heung Sik HS Kim ,Email: kimhs@dsmc.or.kr

Abstract

Purpose
: Recent advances in the methods of treating cancer in young patients have led to both an increased frequency of CNS complications as well as prolonged life expectancy. We intend to analyze the clinical aspects and laboratory findings of patients with CNS complications during and after treatment.
Methods
: We reviewed the medical records of 174 childhood cancer patients treated with chemotherapy admitted to the Dept. of Pediatrics, Keimyung University Dongsan Hospital, from January 1995 to November 2002. Among them, 15 cases with CNS complications were investigated in this study.
Results
: CNS abnormalities were found in 13 patients by CT or MRI during treatment such as leukoencephalopathy(n=7), mineralizing microangiopathy(n=4), brain infarction(n=3), intracranial hemorrhage(n=1), and hypoxic ischemic encephalopathy(n=1). It was found that two patients had two or more CNS abnormalities. Two patients who had no imaging abnormalities had convulsions, possibly after the addition of intrathecal methotrexate. The patients with intracranial hemorrhage and brain infarction had rapid and fatal clinical courses. The hypoxic ischemic encephalopathy following electrolyte imbalance completely recovered after correction of electrolyte.
Conclusion
: The CNS complications that occur during and after chemotherapy influence prognoses significantly, and remain neurologic sequelae. Therefore early diagnosis and prophylaxis for CNS complications and regular physical examination of patients who have recieved cancer therapy are strongly recommended.

Keywords :CNS complication, Chemotherapy, Leukoencephalopathy, Mineralizing microangiopathy, Intracranial hemorrhage, Brain infarction, Hypoxic ischemic encephalopathy