Acute and long-term neurologic complications in children with acute lymphoblastic leukemia

We reviewed the pattern of acute and long-term (during and after treatment period), neurologic complications in children with acute lymphoblastic leukemia (ALL). Among 265 patients, 40 developed neurotoxicity. Twenty-one and 19 of the patients were treated with St. Jude Total XI and St. Jude Total XIII chemotherapy protocols, respectively. There was no difference between Total XI and XIII chemotherapy protocol groups in neurotoxicity. Neurological symptoms were determined during the therapy period in 33 (82.5%) and in the late period in 7 (15%) of 40 patients. Systemic chemotherapy (including vincristine, high-dose methotrexate) and intrathecal chemotherapy seem to be the most common predisposing factors. In the study group, neurological complications in two patients were iatrogenic as a result of lumbar puncture (1 case) and due to erroneous vincristine administration on two consecutive days (1 case).