[P3-35] Chemotherapy related Leukoencephalopathy in Children with Cancers
The aim of this study is to identify the clinical and radiological course of leukoencephalopathy after chemotherapy in children with cancers. We retrospectively reviewed medical records and brain magnetic resonance imagings (MRI) of patients who received chemotherapy for treatment of non - central nervous system malignancy between January 2005 and August 2016. We analyzed data including demographic data, following radiologic imaging scan, neurologic symptoms, onset time of neurologic symptom, treatment and clinical outcome. Of the 327 patients who received chemotherapy between January 2005 and August 2016, sixteen patients (4.9%) were included in the study. They developed leukoencephalopathy after chemotherapy during median follow up of 55 (7.3-133.3) months. Incidence of leukoencephalopathy in ALL was 21.4% (12/56). Neurologic symptom developed in 9 patients (56.3 %) and the most common neurologic symptom was seizure (n=5) followed by headache (n=4) and blurred vision (n=2). The number of patients who received intrathecal methotrexate (MTX) or high dose MTX within 2 weeks were significantly more in symptomatic group than in asymptomatic group. (p = 0.034). Only one out of them who recovered without neurologic deficit developed epilepsy. Brain lesions resolved in 8 of 13 patients on their follow up brain MRI after median onset time of 7.7 (0.9 - 15.7) months. Leukoencephalopathy can be a common chemotherapy related neurotoxicity and many of their clinical symptoms and radiological signs appeared reversible although recovery time was various in each individual. Further studies are needed to identify effect of leukoencephalopathy on long - term neurocognitive sequelae.