Isolated central nervous system relapses in patients with high-risk neuroblastoma -clinical presentation and prognosis: experience of the Polish Paediatric Solid Tumours Study Group.

Autor: Wieczorek A; Department of Paediatric Oncology and Haematology, Faculty of Medicine, Jagiellonian University, Medical College, Krakow, Poland. a.wieczorek@uj.edu.pl., Stefanowicz J; Department of Paediatrics, Haematology and Oncology, Medical University of Gdansk, Gdansk, Poland., Hennig M; Department of Paediatrics, Haematology and Oncology, Medical University of Gdansk, Gdansk, Poland., Adamkiewicz-Drozynska E; Department of Paediatrics, Haematology and Oncology, Medical University of Gdansk, Gdansk, Poland., Stypinska M; Department of Oncology, The Children Memorial Health Institute in Warsaw, Warsaw, Poland., Dembowska-Baginska B; Department of Oncology, The Children Memorial Health Institute in Warsaw, Warsaw, Poland., Gamrot Z; Unit of Paediatric Haematology and Oncology, City Hospital, Chorzow, Poland., Woszczyk M; Unit of Paediatric Haematology and Oncology, City Hospital, Chorzow, Poland., Geisler J; Department of Paediatric Haematology and Oncology, Medical University of Silesia, Zabrze, Poland., Szczepanski T; Department of Paediatric Haematology and Oncology, Medical University of Silesia, Zabrze, Poland., Skoczen S; Department of Paediatric Oncology and Haematology, Faculty of Medicine, Jagiellonian University, Medical College, Krakow, Poland., Ussowicz M; Department and Clinic of Paediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland., Pogorzala M; Paediatric Haematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland., Janczar S; Department of Paediatrics, Oncology and Haematology, Medical University of Lodz, Lodz, Poland., Balwierz W; Department of Paediatric Oncology and Haematology, Faculty of Medicine, Jagiellonian University, Medical College, Krakow, Poland.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2022 Jun 25; Vol. 22 (1), pp. 701. Date of Electronic Publication: 2022 Jun 25.
DOI: 10.1186/s12885-022-09776-x
Abstrakt: Although isolated central nervous system (CNS) relapses are rare, they may become a serious clinical problem in intensively treated patients with high-risk neuroblastoma (NBL). The aim of this study is the presentation and assessment of the incidence and clinical course of isolated CNS relapses. Retrospective analysis involved 848 NBL patients treated from 2001 to 2019 at 8 centres of the Polish Paediatric Solid Tumours Study Group (PPSTSG). Group characteristics at diagnosis, treatment and patterns of relapse were analysed. Observation was completed in December 2020. We analysed 286 high risk patients, including 16 infants. Isolated CNS relapse, defined as the presence of a tumour in brain parenchyma or leptomeningeal involvement, was found in 13 patients (4.5%; 8.4% of all relapses), all of whom were stage 4 at diagnosis. Isolated CNS relapses seem to be more common in young patients with stage 4 MYCN amplified NBL, and in this group they may occur early during first line therapy. The only or the first symptom may be bleeding into the CNS, especially in younger children, even without a clear relapse picture on imaging, or the relapse may be clinically asymptomatic and found during routine screening. Although the incidence of isolated CNS relapses is not statistically significantly higher in patients after immunotherapy, their occurrence should be carefully monitored, especially in intensively treated infants, with potential disruption of the brain-blood barrier.
(© 2022. The Author(s).)
Databáze: MEDLINE
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