Effect of Intrathecal Methotrexate Injectionon Neurocognitive Functions in Children with Non Hodgkin Lymphoma after Treatment

Document Type : Original Article

Authors

1 Department of Pediatrics Faculty of Medicine, University of Sohag

2 Department of Phoniatrics unit, Faculty of Medicine, Sohag University

Abstract

Introduction and aim of work: Neurocognitive late effects are common sequelae of cancer in children, especially in those who have undergone treatment for brain tumors or in those receiving prophylactic cranial radiation or intrathecal chemotherapy therapy to treat leukemia and non Hodgkin lymphoma (NHL). As NHL represents 8–10% of all malignancies in children between 5–19 years of age (Cairo, 2009)  and all NHL children receive intrathecal methotrexate as therapy or prophylaxis so we studied effect of intrathecal methotrexate in NHL treated children in their cognitive function and compare it with normal children, also we studied effect of some risk factors (age at disease onset and number of intrathecal injections) on the affected intelligence subscales and lastly a suitable and applicable model to evaluate neurocognitive function was done.
Patients and methods: The study included 25 NHL treated children and 10 children as controls, all children are subjected to some specific neurocognitive tests and sheet for assessment of neurocognitive function as complementary study.
Result: It showed that total IQ score, verbal and quantitative subscales are significantly affected in NHL patients and verbal subscale is more affected in children who began treatment at younger age

References

  1. Anderson VA, Godber T, Smibert E, Weiskop S, Ekert H (2000). Cognitive and academic outcome following cranial irradiation and chemotherapy in children: a longitudinal study. Br J Cancer 82:255-62.
  2. Anderson, John R (2004). Cognitive psychology and its implications (6th ed.). Worth Publishers. 519. ISBN 978-0-7167-0110-1.
  3. Buizer AI, de Sonneville LM, Veerman A (2009). Effects of chemotherapy on neurocognitive function in children with acute lymphoblastic leukemia: A critical review of the literature. Pediatr Blood Cancer 52:447–54.
  4. Cairo MS (2009). Non-Hodgkin’s Lymphoma and Lymphoproliferative Disorders in Children. In: Carroll WL, FinlayJL, eds. Cancer in Children and Adolescents. Jones & Bartlett Publishers, available online.
  5. Carey ME, Haut MW, Reminger SL (2008). Reduced frontal white matter volume in long term childhood leukemia survivor: A voxel–based morphology study. Am J Neurological 29:792-797.
  6. Gangjee A, Jain HD, Kurup S (2007).Recent advances in classical and non-classical antifolates as antitumor and antiopportunistic infection agents: part I. Anticancer Agents Med Chem 7(5):524–42.
  7. Garcia-Puig M, Fons-Estupina MC, Rives-Sola S, Berrueco-Moreno R, Cruz-Martinez O, Campistol J (2012). Neurotoxicity due to methotrexate in paediatric patients.
  8. Description of the clinical symptoms and neuroimaging findings. Rev Neurol.  54(12):712-8
  9. Hassab HM, Azouz HG, Elsakka EE, Awwad HE (2015). Assessment of Cognitive Function in Children with Acute Lymphoblastic Leukemia. Annals of Clinical and Laboratory Research ISSN 2386-5180 (special issue):1-10.
  10. Iuvone L, Mariotti P, Colosimo C, Guzzetta F, Ruggiero A (2002). Long-term cognitive outcome, brain computed tomography scan, and magnetic resonance imaging in children cured for acute lymphoblastic leukemia. Cancer 95:2562-70.
  11. Iyer NS, Balsamo LM, Bracken MB, Kadan-Lottick NS (2015). Chemotherapy-only treatment effects on long-term neurocognitive functioning in childhood ALL survivors: a review and meta-analysis. Blood. 126(3):346-53.
  12. Kadan-Lottick NS, Zeltzer LK, Liu Q (2017). The Behavior Rating Inventory of Executive Function (BRIEF) to Identify Pediatric Acute Lymphoblastic Leukemia (ALL) Survivors At Risk for Neurocognitive Impairment J Pediatr Hematol Oncol.. 102(12):881-93.
  13. Kaemingk KL, Carey Me, Moore IM (2004). Math weakness in survivor of ALL compared to healthy children, Child Neuropsychol 10;14-23.
  14. Kanellopoulos A, Andersson S, Zeller B, Tamnes CK, Fjell AM, Walhovd KB (2017). Neurocognitive Outcome in Very Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia After Treatment with Chemotherapy Only. Pediatric blood & cancer. 63(1):133-8.
  15. LAILA M. SHERIEF, USAMA R. ELSAFY, ELHAMY R.            ABDELKHALEK, NAGLAA M. KAMAL, DOAA M. YOUSSEF , RABAB ELBEHEDY (2015) Disease patterns of pediatric non-Hodgkin lymphoma: A   study from a developing area in Egypt .Mol Clin Oncol. 2015 Jan; 3(1): 139–144.
  16. Langer T, Martus P, Ottensmeier H, Hertzberg H, Beck JD (2002). CNS late-effects after ALL therapy in childhood. Part III: neuropsychological performance in long-term survivors of childhood ALL: impairments of concentration, attention, and memory. Med Pediatr Oncol 38:320-8.
  17. Lanzkowsky ,Jeffery Lipton and Jonathan Fish (2016); Evaluation, investigation and management of late effects of childhood cancer
  18. Lyon G, Fattal-Valevski A, Kolodny EH (2006). Leukodystrophies: Topics in Magnetic Resonance Imaging. 17(4):219–42
  19. Miller DR (2006). A tribute to Sidney Farber – the father of modern chemotherapy. British Journal of Haematology 134(1):20–6.
  20. Mukherjee S (2010). The Emperor of All Maladies: A Biography of Cancer. Simon and Schuster. ISBN 978-1-4391-0795-9, available online.
  21. Mulhern RK, Palmer SL, Reddick WE, Glass JO, Kun LE (2001). Risks of young age for selected neurocognitive deficits in medulloblastoma are associated with white matter loss. J Clin Oncol 19:472-9.
  22. Reddick WE, Russell JM, Glass JO, Xiong X, Mulhern RK (2000). Subtle white matter volume differences in children treated for medulloblastoma with conventional or reduced dose craniospinal irradiation. Magn Reson Imaging 18:787-93.
Sohag Medical Journal
Volume 21, Issue 1
January 2017
Pages 265-272

Files

Share

How to cite

Statistics