Electrophysiological study of peripheral nerves in children with acute lymphoblastic leukemia

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Abstract

Background

Acute lymphoblastic leukemia (ALL) is a malignant disorder of lymphoid progenitor cells affecting both children and adults. Chemotherapy-induced peripheral neurotoxicity is an important side effect of several chemotherapeutic agents.

Objectives

The aim of this study was to detect the presence and types of peripheral neuropathy (PN) in newly diagnosed children with ALL, before and after the phase of induction of remission.

Methodology

A total of 24 children newly diagnosed with ALL were enrolled into the study (group I). They were subjected to clinical and electrodiagnostic assessments to examine the integrity of the peripheral nervous system before and after receiving chemotherapeutic agents. Ten apparently healthy children served as controls (group II).

Results

Electrodiagnostic assessment revealed that 16 children (67%) had no documented PN, whereas eight (33%) had PN. Of these eight children, two (8.3%) were proven to have chemotherapy-induced PN, four (16.6%) had subclinical chemotherapy-induced PN, and two (8.3%) had subclinical PN due to ALL. Of the eight children with PN, five (62.5%) had an axonal pattern, one (12.5%) had a demyelinating pattern, and two (25%) had a mixed axonal demyelinating pattern of affection. In general, the affection of peripheral motor nerves was greater compared with sensory nerve affection.

Conclusion

Chemotherapeutic agents used in the treatment of ALL (phase I: induction of remission) proved to have neurotoxic effects on peripheral nerves. In most children, the PN was subclinical.

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