儿童急性淋巴细胞白血病合并癫痫发作的研究_Journal of Epilepsy

Authors：

周文杰 ,  汤继宏

苏州大学附属儿童医院神经内科（苏州 215025）;

Corresponding author：

汤继宏, Email: tjhzsh@126.com

Keywords：

急性淋巴细胞白血病; 癫痫发作；儿童

DOI：

10.7507/2096-0247.20200039

Video：

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急性淋巴细胞白血病（Acute lymphoblastic leukemia，ALL）是儿童白血病最常见的类型，在急性治疗期间癫痫发作并不少见。据报道，在 8%～13% 的 ALL 患者中可见癫痫发作，多发生在化疗诱导和中枢神经系统巩固的急性治疗阶段，诱导缓解的前 6 周内，化疗药物的不良反应可增加癫痫发作风险。大多数癫痫是急性症状性，对早期治疗阶段首次发作的 ALL 患者的评估应从颅脑成像开始，除非代谢原因立即显现出来，否则，所有癫痫发作的患者都应进行颅脑核磁共振（MRI）检查，仅有少数患者需长期使用抗癫痫药物（AEDs）治疗，AEDs 的选择应考虑到与化疗或支持药物的潜在相互作用，癫痫发作后可导致神经系统后遗症，需早期诊断、早期治疗。现就 ALL 合并癫痫发作的特点作一综述。

Citation： 周文杰, 汤继宏. 儿童急性淋巴细胞白血病合并癫痫发作的研究. Journal of Epilepsy, 2020, 6(3): 220-223. doi: 10.7507/2096-0247.20200039 Copy

1.	Kaprin AD, Starinskij VV, Petrov GV, Eds//Malignant neoplasms in Russia in 2015 (morbidity and mortality). Moscow, Herzen MORI-branch of the NMRRC of the Ministry of Health of the Russian Federation, 2017: 1- 250.
2.	Pui CH, Yang JJ, Hunger SP, et al. Childhood acute lymphoblastic leukemia:progressthroughcollaboration. J ClinOncol, 2015, 33(11): 2938-2948.
3.	Maytal J, Grossman R, Yusuf FH, et al. Prognosis and treatment of seizures in children with acute lymphocytic leukemia. Epilepsia, 1995, 36(5): 831-836.
4.	Rao RD, Swanson JW, Dejesus RS, et al. Methotrexate induced seizures associated with acute reversible magnetic resonance imaging (MRI) changes in a patient with acute lymphoblastic leukemia. Leukemia & Lymphoma, 2002, 43(6): 1333-1336.
5.	Guruprasad CS, Binitha R, Nair M, et al. Etiological profile of seizures in children undergoing chemotherapy for acute lymphoblastic leukemia. Pediatric Hematology Oncology Journal, 2016, 1(Suppl a): 12.
6.	Wang T, Yen H, Hung G, et al. A rare complication in a child undergoing chemotherapy for acute lymphoblastic leukemia: superior sagittal sinus thrombosis. Journal of the Chinese Medical Association, 2011, 74(1): 183-187.
7.	Fasano RE, Bergen DC. Intractable epilepsy in patients treated for childhood acute lymphocytic leukemia. Seizure, 2008, 18(2): 298-302.
8.	Hamamoto K, Oriuchi N, Kanazawa T, et al. Mesial temporal sclerosis associated with methotrexate-induced leukoencephalopathy. Pediatric Neurology, 2009, 40(2): 306-309.
9.	El-Bitar M, Muwakkit S, Dabbagh O. Severe hypoglycemic seizures in a child receiving 6-mercaptopurine. J Pediotr Hematol Orval, 2011, 33: e75-e76.
10.	Mahapatra M, Kumar R, Choudhry VP. Seizures as an adverse drug reaction after therapeutic dose of vincristine. Annals of Hematology, 2007, 86(2): 153-154.
11.	Antunes NL. Seizures in children with systemic cancer. Pediatric Neurology, 2003, 28(2): 190-193.
12.	Bhatia R, Rowley HD, Mosher JC, et al. Extensive sinovenous thrombosis and hemorrhagic infarction during therapy for T-Cell acute lymphoblastic leukemia. Pediatric Emergency Care, 2013, 29(1): 93-97.
13.	Santoro N, Giordano P, Del Vecchio GC, et al. Ischemic stroke in children treated for acute lymphoblastic leukemia: a retrospective study. J Pediatr Hematol Oncol, 2005, 27(2): 153-157.
14.	Linnebank M, Pels H, Kleczar N, et al. Methotrexate induced white matter changes are associated with polymorphisms of methionine metabolism. Neurology, 2005, 64(6): 912-913.
15.	Forster VJ, van Delft FW, Baird SF, et al. Drug interactions may be important risk factors for methotrexate neurotoxicity, particularly in pediatric leukemia patients. Cancer Chemother and Pharmacol, 2016, 78(9): 1093-1096.
16.	Haykin ME, Gorman M, van Hoff J, et al. Diffusion-weighted MRI correlates of subacute methotrexate-related neurotoxicity. J Neurooncol, 2006, 76(1): 153-157.
17.	Vezmar S, Becker A, Bode U, et al. Biochemical and clinical aspects of methotrexate neurotoxicity. Chemotherapy, 2003, 49(1): 92-104.
18.	Bhojwani D, Sabin N, Pei D, et al. Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. Journal of Clinical Oncology, 2014, 32(6): 949-949.
19.	Mahapatra M, Kumar R, Choudhry VP. Seizures as an adverse drug reaction after therapeutic dose of vincristine. Annals of Hematology, 2007, 86(1): 153-154.
20.	Kim SJ, M D, I m, Soo Ah, et al. Predisposing factors of posterior reversible encephalopathy syndrome in acute childhood leukemia. Pediatric Neurology, 2012, 47(3): 436-442.
21.	Anastasopoulou S, Eriksson MA, Heyman M, et al. Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia: clinical characteristics, risk factors, course, and outcome of disease. Pediatric Blood & Cancer, 2018, 16: e27594.
22.	Parasole R, Petruzziello F, Menna G, et al. Central nervous system complications during treatment of acute lymphoblastic leukemia in a single pediatric institution. Leuk Lymphoma, 2010, 51(7): 1063-1071.
23.	Zama D, Gasperini P, Berger M, et al. A survey on hematologyoncology pediatric AIEOP centres: the challenge of posterior reversible encephalopathy syndrome. Eur J Haematol, 2018, 100(1): 75-82.
24.	Arzanian MT, Shamsian BS, Karimzadeh P, et al. Posterior reversible encephalopathy syndrome in pediatric hematologiconcologic disease: literature review and case presentation. Iran J Child Neurol, 2014, 8(1): 1-10.
25.	Granata G, Greco A, Iannella G, et al. Posterior reversible encephalopathy syndrome-insight into pathogenesis, clinical variants and treatment approaches. Autoimmun Rev, 2015, 14(5): 830-836.
26.	Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol, 2015, 14(4): 914-925.
27.	Banerjee JS, Heyman M, Palomaki M, et al. Posterior reversible encephalopathy syndrome: risk factors and impact on the outcome in children with acute lymphoblastic leukemia treated with Nordic protocols. J PediatrHematol Oncol, 2018, 40(1): 13-18.
28.	de Laat P, Te Winkel ML, Devos AS, et al. van den Heuvel-eibrink MM. Posterior reversible encephalopathy syndrome in childhood cancer. Ann Oncol, 2011, 22(3): 472-478.
29.	Schmiegelow K, Attarbaschi A, Barzilai S, et al. Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a delphi consensus. Lancet Oncology, 2016, 17(2): 231-239.
30.	Schederkina IO, Tiganova OA, Koltunov IE, et al. Epilepsy in children with lymphoproliferative syndrome. Epilepsia and Paroxyzmal Conditions, 2018, 10(1): 82-94.
31.	Relling MV, Pui C, Sandlund JT, et al. Adverse effect of anticonvulsants on efficacy of chemotherapy for acute lymphoblastic leukaemia. The Lancet, 2000, 356: 285-290.
32.	Baytan B, Evim MS, Güler S, et al. Acute central nervous system complications in pediatric acute lymphoblastic leukemia. Pediatric Neurology, 2015, 53(2): 312-318.
33.	Millan NC, Pastrana A, Guitter MR, et al. Acute and sub-acute neurological toxicity in children treated for acute lymphoblastic leukemia. Leukemia Research, 2018, 65(1): 86-93.

1. Kaprin AD, Starinskij VV, Petrov GV, Eds//Malignant neoplasms in Russia in 2015 (morbidity and mortality). Moscow, Herzen MORI-branch of the NMRRC of the Ministry of Health of the Russian Federation, 2017: 1- 250.
2. Pui CH, Yang JJ, Hunger SP, et al. Childhood acute lymphoblastic leukemia:progressthroughcollaboration. J ClinOncol, 2015, 33(11): 2938-2948.
3. Maytal J, Grossman R, Yusuf FH, et al. Prognosis and treatment of seizures in children with acute lymphocytic leukemia. Epilepsia, 1995, 36(5): 831-836.
4. Rao RD, Swanson JW, Dejesus RS, et al. Methotrexate induced seizures associated with acute reversible magnetic resonance imaging (MRI) changes in a patient with acute lymphoblastic leukemia. Leukemia & Lymphoma, 2002, 43(6): 1333-1336.
5. Guruprasad CS, Binitha R, Nair M, et al. Etiological profile of seizures in children undergoing chemotherapy for acute lymphoblastic leukemia. Pediatric Hematology Oncology Journal, 2016, 1(Suppl a): 12.
6. Wang T, Yen H, Hung G, et al. A rare complication in a child undergoing chemotherapy for acute lymphoblastic leukemia: superior sagittal sinus thrombosis. Journal of the Chinese Medical Association, 2011, 74(1): 183-187.
7. Fasano RE, Bergen DC. Intractable epilepsy in patients treated for childhood acute lymphocytic leukemia. Seizure, 2008, 18(2): 298-302.
8. Hamamoto K, Oriuchi N, Kanazawa T, et al. Mesial temporal sclerosis associated with methotrexate-induced leukoencephalopathy. Pediatric Neurology, 2009, 40(2): 306-309.
9. El-Bitar M, Muwakkit S, Dabbagh O. Severe hypoglycemic seizures in a child receiving 6-mercaptopurine. J Pediotr Hematol Orval, 2011, 33: e75-e76.
10. Mahapatra M, Kumar R, Choudhry VP. Seizures as an adverse drug reaction after therapeutic dose of vincristine. Annals of Hematology, 2007, 86(2): 153-154.
11. Antunes NL. Seizures in children with systemic cancer. Pediatric Neurology, 2003, 28(2): 190-193.
12. Bhatia R, Rowley HD, Mosher JC, et al. Extensive sinovenous thrombosis and hemorrhagic infarction during therapy for T-Cell acute lymphoblastic leukemia. Pediatric Emergency Care, 2013, 29(1): 93-97.
13. Santoro N, Giordano P, Del Vecchio GC, et al. Ischemic stroke in children treated for acute lymphoblastic leukemia: a retrospective study. J Pediatr Hematol Oncol, 2005, 27(2): 153-157.
14. Linnebank M, Pels H, Kleczar N, et al. Methotrexate induced white matter changes are associated with polymorphisms of methionine metabolism. Neurology, 2005, 64(6): 912-913.
15. Forster VJ, van Delft FW, Baird SF, et al. Drug interactions may be important risk factors for methotrexate neurotoxicity, particularly in pediatric leukemia patients. Cancer Chemother and Pharmacol, 2016, 78(9): 1093-1096.
16. Haykin ME, Gorman M, van Hoff J, et al. Diffusion-weighted MRI correlates of subacute methotrexate-related neurotoxicity. J Neurooncol, 2006, 76(1): 153-157.
17. Vezmar S, Becker A, Bode U, et al. Biochemical and clinical aspects of methotrexate neurotoxicity. Chemotherapy, 2003, 49(1): 92-104.
18. Bhojwani D, Sabin N, Pei D, et al. Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. Journal of Clinical Oncology, 2014, 32(6): 949-949.
19. Mahapatra M, Kumar R, Choudhry VP. Seizures as an adverse drug reaction after therapeutic dose of vincristine. Annals of Hematology, 2007, 86(1): 153-154.
20. Kim SJ, M D, I m, Soo Ah, et al. Predisposing factors of posterior reversible encephalopathy syndrome in acute childhood leukemia. Pediatric Neurology, 2012, 47(3): 436-442.
21. Anastasopoulou S, Eriksson MA, Heyman M, et al. Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia: clinical characteristics, risk factors, course, and outcome of disease. Pediatric Blood & Cancer, 2018, 16: e27594.
22. Parasole R, Petruzziello F, Menna G, et al. Central nervous system complications during treatment of acute lymphoblastic leukemia in a single pediatric institution. Leuk Lymphoma, 2010, 51(7): 1063-1071.
23. Zama D, Gasperini P, Berger M, et al. A survey on hematologyoncology pediatric AIEOP centres: the challenge of posterior reversible encephalopathy syndrome. Eur J Haematol, 2018, 100(1): 75-82.
24. Arzanian MT, Shamsian BS, Karimzadeh P, et al. Posterior reversible encephalopathy syndrome in pediatric hematologiconcologic disease: literature review and case presentation. Iran J Child Neurol, 2014, 8(1): 1-10.
25. Granata G, Greco A, Iannella G, et al. Posterior reversible encephalopathy syndrome-insight into pathogenesis, clinical variants and treatment approaches. Autoimmun Rev, 2015, 14(5): 830-836.
26. Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol, 2015, 14(4): 914-925.
27. Banerjee JS, Heyman M, Palomaki M, et al. Posterior reversible encephalopathy syndrome: risk factors and impact on the outcome in children with acute lymphoblastic leukemia treated with Nordic protocols. J PediatrHematol Oncol, 2018, 40(1): 13-18.
28. de Laat P, Te Winkel ML, Devos AS, et al. van den Heuvel-eibrink MM. Posterior reversible encephalopathy syndrome in childhood cancer. Ann Oncol, 2011, 22(3): 472-478.
29. Schmiegelow K, Attarbaschi A, Barzilai S, et al. Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a delphi consensus. Lancet Oncology, 2016, 17(2): 231-239.
30. Schederkina IO, Tiganova OA, Koltunov IE, et al. Epilepsy in children with lymphoproliferative syndrome. Epilepsia and Paroxyzmal Conditions, 2018, 10(1): 82-94.
31. Relling MV, Pui C, Sandlund JT, et al. Adverse effect of anticonvulsants on efficacy of chemotherapy for acute lymphoblastic leukaemia. The Lancet, 2000, 356: 285-290.
32. Baytan B, Evim MS, Güler S, et al. Acute central nervous system complications in pediatric acute lymphoblastic leukemia. Pediatric Neurology, 2015, 53(2): 312-318.
33. Millan NC, Pastrana A, Guitter MR, et al. Acute and sub-acute neurological toxicity in children treated for acute lymphoblastic leukemia. Leukemia Research, 2018, 65(1): 86-93.

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儿童急性淋巴细胞白血病合并癫痫发作的研究

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