Neurotoxic side effects in children with refractory or relapsed T-cell malignancies treated with nelarabine based therapy
Neurotoxic side effects in children with refractory or relapsed T-cell malignancies treated with nelarabine based therapy
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DOI：
10.1111/bjh.14877
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发表时间：
2017-10-01
影响因子：
6.5
通讯作者：
Chen-Santel, Christiane
中科院分区：
文献类型：
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作者：
Kuhlen, Michaela;Bleckmann, Kirsten;Chen-Santel, Christiane
儿童难治性或复发性（r/r）T细胞急性淋巴细胞白血病（T-ALL）或淋巴母细胞淋巴瘤（T-LBL）的预后很差。奈拉滨（Ara-G）已成功用于这些儿童的挽救治疗，但与显著的，甚至致命的神经毒性相关。我们回顾性分析了52例年龄≥ III级的r/r T-ALL/T-LBL患者。最常见的神经AE为周围运动神经病变（19.2%）、周围感觉神经病变（11.5%）和癫痫发作（9.6%）。3例患者在1-2个周期的联合治疗后死于中枢神经系统AE。有神经毒性的患者年龄（中位数15.17岁）明显大于无神经毒性的患者（10.34岁，P = 0.017）。在结局和神经AE方面，未观察到单药和联合治疗之间的差异。神经AE的发生率与同时鞘内治疗或既往中枢神经系统放疗无关。
The prognosis in children with refractory or relapsed (r/r) T-cell acute lymphoblastic leukaemia (T-ALL) or lymphoblastic lymphoma (T-LBL) is poor. Nelarabine (Ara-G) has successfully been used as salvage therapy in these children, but has been associated with significant, even fatal, neurotoxicities. We retrospectively analysed 52 patients with r/r T-ALL/T-LBL aged = grade III. The most frequent neuro-AEs were peripheral motor neuropathy (19.2%), peripheral sensory neuropathy (11.5%) and seizures (9.6%). Three patients died of central neuro-AE after 1-2 cycles of combination therapy. Patients with neurotoxicity were significantly older (median 15.17 years) than those without (10.34 years, P = 0.017). No differences were observed between mono-and combination therapy concerning outcome and neuro-AE. The incidence of neuro-AE was not associated with concurrent intrathecal therapy or prior central nervous system irradiation.