Complicaciones neurológicas en pacientes y con Leucemia Linfoblástica Aguda del Hospital Francisco Icaza Bustamante en el periodo 2017-2022.

Abstract

Background: neurological complications in pediatric patients with ALL represent a problem in the course of the disease, compromising the prognosis due to discontinuation of treatment in cases of neuropathies or neurotoxicity secondary to chemotherapeutic agents, neuroinfections resulting from the state of neutropenia, cerebrovascular disease due to cerebral leukostasis or thrombocytopenia, infiltration of the CNS producing alteration of the state of consciousness, convulsions and even death. Materials and methods: A retrospective study was conducted through 280 pediatric medical records within the Francisco Icaza Bustamante Hospital in the hemato-oncology area with a diagnosis of acute lymphoblastic leukemia in the period from May 2017 to October 2022. Those patients were included in the study. who presented neurological manifestations during the course of their disease, grouping data in an Excel file and in IMB SPSS, analyzing the frequency and significance of the variables. Results: Of the 280 clinical histories, 78 (27.8%) developed complications in the nervous system, being more frequent in children with 61 (78.2%) within the age range 6-10 with a frequency of 37 (47.4%). Neurological complications were 55 (70.5%) CNS infiltration; 13 (16.7%) drug-induced polyneuropathy; 7 (9.0%) intracerebral hemorrhage; 5 (6.4%) reversible posterior encephalopathy; 3 (3.8%) drug neurotoxicity; 2 (2.8%) ischemic cerebrovascular disease, 2 (2.8%) acute subdural hematoma, 1 (1.3%) transient ischemic attack, and 1 (1.3%) methotrexate encephalopathy. Conclusions: The most frequent neurological complication in patients with ALL is infiltration in the nervous system whose symptoms are very general and non-specific and in most cases do not present neurological manifestations.