Clinical utility of complex assessment with evoked potentials in acute lymphoblastic leukemia survivors: comparison of various treatment protocols

Autor: Eryk Kapusta, Paweł Skorek, Izabela Witek-Motyl, Konrad Stepien, Kinga Kwiecinska, Sławomir Kroczka, Szymon Skoczeń, Agnieszka Biedron
Rok vydání: 2020
Předmět:
0301 basic medicine
Adult
Male
Cancer Research
medicine.medical_specialty
Diagnostic methods
Adolescent
Lymphoblastic Leukemia
Joint analysis
Acute lymphoblastic leukemia
Somatosensory system
lcsh:RC254-282
Objective assessment
03 medical and health sciences
Young Adult
0302 clinical medicine
Cancer Survivors
Internal medicine
Evoked Potentials
Somatosensory
Genetics
Evoked Potentials
Auditory
Brain Stem
Medicine
Humans
Survivors
Children
Subclinical infection
Radiotherapy
business.industry
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Evoked potentials
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
Combined Modality Therapy
Survival Rate
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Child
Preschool
Evoked Potentials
Visual
Female
Pediatric hematology
business
Research Article
Zdroj: BMC Cancer
BMC Cancer, Vol 21, Iss 1, Pp 1-13 (2021)
ISSN: 1471-2407
Popis: Background One of the greatest success of pediatric hematology is a prominent improvement of survival in acute lymphoblastic leukemia (ALL). Therefore, special attention needs to be paid to long-term side effects of the treatment such as neurotoxicity. One of the few diagnostic methods that allow an objective assessment of sensory systems are evoked potentials (EP). Methods The analyzed group consisted of 167 ALL long-term survivors, aged 4.9–28.4 years, without auditory, visual and sensory deviations. Patients were treated with New York (NY, n = 35), previous modified Berlin-Frankfurt-Münster (pBFM, n = 47) and BFM95 (n = 85) protocols. In order to assess the impact of radiotherapy on recorded EP, a joint analysis of NY and pBFM groups was performed. The control group consisted of 35 patients, aged 6–17 years. The analyzed patients underwent a complex assessment with visual EP (VEP), somatosensory EP (SEP) and brainstem auditory EP (BAEP) in accordance with current standards. Results ALL treatment contributed to the shortening of wave I latency (1.59 vs 1.90, P = 0.003) and prolongation of I-III (2.23 vs 2.04, P = 0.004) and I-V (4.57 vs 4.24, P = 0.002) interwave latencies of BAEP. A significant effect was also noticed in P100 (106.32 vs 101.57, P P P = 0.007) and P25 latency (21.32 vs 23.39, P < 0.001) of SEP. The distribution of abnormalities between protocols was similar in BAEP (NY - 68.6%, pBFM - 61.7%, BFM95–69.4%, P = 0.650), VEP (NY - 68.6%, pBFM - 42.5%, BFM95–58.3%, P = 0.053) and significantly different for SEP (NY - 62.9%, pBFM - 36.2%, BFM95–53.0%, P = 0.045). The harmful effect of radiotherapy was most clearly marked in numerous disturbances of SEP parameters. Conclusions The presented analysis indicates a high frequency of subclinical abnormalities in EP regardless of the analyzed protocol. To our knowledge current study is the largest and one of the most complex research examining the role of EP in ALL patients. The obtained results indicate the possibility of using a single, objective and non-invasive measurement of EP in ALL survivors in order to stratify the risk of developing sensory abnormalities in adulthood.
Databáze: OpenAIRE
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