Cruz-Chávez Diana Alejandra, López-Pérez Brian Javier, Solórzano-Gómez Elsa, Venta-Sobero José Antonio, Flores-Villegas Luz Victoria, Toledo-Lozano Christian Gabriel, Castro-Loza Gabriela Vianney, Sandoval-Pacheco Roberto, Torres-Vallejo Andrea, Marmol-Realpe Karen Sharlot Faisury, Flores-Jurado Yazmín Evelyn, Hernández-Soriano Cristal Lucero, Alcaraz-Estrada Sofía Lizeth, Mondragón-Terán Paul, Suárez-Cuenca Juan Antonio, Coral-Vázquez Ramón Mauricio, Garcia Silvia
Department of Pediatric Neurology, Centro Médico Nacional "20 de Noviembre", Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Mexico City 03229, Mexico.
Department of Pediatric Hematology, Centro Médico Nacional "20 de Noviembre", Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Mexico City 03229, Mexico.
Children (Basel). 2022 Aug 23;9(9):1268. doi: 10.3390/children9091268.
Acute leukemia (AL) is an important cause of morbidity and mortality in children, and neurological manifestations (NM) are frequent. The objective of this study was to analyze neurological manifestations in children with acute leukemia from cases attended in the last five years at the Centro Médico Nacional "20 de Noviembre".
Conducting a retrospective and analytical study from 1 January 2015 to 31 December 2020 in children with AL classified according to sex, age range and AL type. Participants were grouped according the presence of NM.
We analyzed 607 patients: 54.85% boys and 44.14% girls, with a mean age of 7.27 ± 4.54 years. When comparing groups, the NM group was significantly older ( = 0.01), and the highest prevalence was between 6 and 12 years old. ALL was predominant over the other lineages ( ≤ 0.01). The most frequent NM was CNS infiltration, seizures, headache and neuropathy. Death outcomes occurred in 18.7% of children with AML, 11.8% with ALL and 50% with MPAL ( ≤ 0.002). The NM group was associated with higher mortality during a follow-up time of 77.9 ± 49 months (44.4% vs. 8.9% deaths, NM vs. non-NM, respectively; OR = 3.3; 95% CI 2.4 to 4.6; ≤ 0.0001).
ALL was the most prevalent leukemia type. CNS infiltration, seizures, headache, neuropathy and PRES were the most frequent symptoms in the NM group. NM was associated with a higher mortality rate.
急性白血病（AL）是儿童发病和死亡的重要原因，且神经学表现（NM）很常见。本研究的目的是分析在国家医学中心“11月20日”过去五年就诊的急性白血病患儿的神经学表现。
对2015年1月1日至2020年12月31日的急性白血病患儿进行回顾性分析研究，根据性别、年龄范围和急性白血病类型进行分类。参与者根据是否存在神经学表现进行分组。
我们分析了607例患者：男孩占54.85%，女孩占44.14%，平均年龄为7.27±4.54岁。在比较各组时，神经学表现组年龄显著更大（P = 0.01），最高患病率在6至12岁之间。急性淋巴细胞白血病（ALL）比其他谱系更常见（P≤0.01）。最常见的神经学表现是中枢神经系统浸润、癫痫发作、头痛和神经病变。急性髓细胞白血病（AML）患儿的死亡结局发生率为18.7%，急性淋巴细胞白血病患儿为11.8%，混合表型急性白血病（MPAL）患儿为50%（P≤0.002）。在77.9±49个月的随访期内，神经学表现组的死亡率更高（分别为44.4%和8.9%，神经学表现组与无神经学表现组；比值比 = 3.3；95%置信区间2.4至4.6；P≤0.0001）。
急性淋巴细胞白血病是最常见的白血病类型。中枢神经系统浸润、癫痫发作、头痛、神经病变和可逆性后部白质脑病综合征（PRES）是神经学表现组最常见的症状。神经学表现与更高的死亡率相关。
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