ABSTRACT
PURPOSE: Chemo- and radiotherapy used in acute lymphoblastic leukemia (ALL) can influence on brain functioning in the future. In a prospective study we analysed the cognitive functions of ALL survivors in relation to Tau protein as a marker of white matter injury. MATERIAL AND METHODS: Thirty-one survivors of childhood ALL (6.3 years after diagnosis); without the signs of CNS involvement, treated with chemotherapy alone, rested in first remission; underwent Intelligence tests- Wechsler Intelligence Scales (WISC-R, WAIS-R). Their results were analyzed in relation to the levels of Tau in cerebrospinal fluid (CSF) obtained during the treatment. RESULTS: The analysis showed that all survivors attained the average scores in intelligence tests. A negative correlation was found between methotrexate (MTX) doses and Freedom from Distractibility (FFD). Females had higher values of Performance Intelligence Quotient (PIQ) than males. A negative correlation was noted of Tau protein levels obtained from the last CSF with: Total and Verbal Intelligence Quotient, PIQ, Perceptual Organisation Index and FFD but not with Verbal Comprehension Index. CONCLUSION: Our results suggest the possibility of white matter injury during the treatment for ALL with chemotherapy alone. Elevated Tau protein level in CSF at the end of treatment might indicate future difficulties in neurocognitive functioning.
Subject(s)
Brain Injuries/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/psychology , tau Proteins/cerebrospinal fluid , Adolescent , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Biomarkers/cerebrospinal fluid , Brain Injuries/cerebrospinal fluid , Brain Injuries/psychology , Child , Child, Preschool , Cognition Disorders/cerebrospinal fluid , Cognition Disorders/etiology , Female , Humans , Intelligence , Male , Methotrexate/administration & dosage , Methotrexate/adverse effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/cerebrospinal fluid , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapyABSTRACT
The aim of the study was to investigate the levels of cerebrospinal fluid (CSF) cytokines during chemotherapy of acute lymphoblastic leukaemia (ALL). Examination of 12 ALL child (6 boys and 6 girls) patients evidenced significant increases in interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) after induction treatment and significant increases in IL-6, tumour necrosis factor-α (TNF-α) and MCP-1 levels during the consolidation phase, as compared to their values at the time of diagnosis. There were no significant differences in CSF IL-6, TNF-α and MCP-1 concentrations after therapy. Our data suggest that standard ALL treatment may cause a subclinical inflammation and neurotoxicity.
Subject(s)
Cytokines/cerebrospinal fluid , Precursor Cell Lymphoblastic Leukemia-Lymphoma/cerebrospinal fluid , Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology , Adolescent , Antineoplastic Agents/adverse effects , Chemokine CCL2/cerebrospinal fluid , Child , Child, Preschool , Female , Humans , Inflammation , Interleukin-6/cerebrospinal fluid , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Tumor Necrosis Factor-alpha/cerebrospinal fluidABSTRACT
PURPOSE: The aim of the study was to compare sleep-wake schedules between snoring and nonsnoring preschool age children. MATERIAL AND METHODS: Daytime and nighttime sleep duration, daytime and nighttime symptoms were assessed in 34 children at preschool age who snore (5.38+/-1.21 years) and in 66 age- and sex-matched nonsnorers (5.67+/-1.12 years). The snoring group consisted of children with obstructive sleep apnea (OSA) scores <+3.5 and >-1, the nonsnoring group with OSA score <-1. RESULTS: Children who snore differ from the nonsnorers in daytime sleep duration (51.62+/-28.9 minutes vs. 10.70+/-20.2 minutes; p<0.001), but not in nighttime sleep (10.97+/-0.52 hours vs. 9.83+/-1.34 hours; p>0.05). The percentage of children with daytime napping was higher in the snoring group than in the nonsnorers (47.1% vs. 9.1%; p<0.00004), and parents-reported behavioral problems were more frequent in children who snore (41.2% vs. 19.7%; p<0.02). Multivariate odds ratios, including variables for nighttime (sleep apnea) and daytime symptoms (daytime napping and oral breathing), showed that regular sleep during the day was the most predictive of snoring (OR=6.1; 95%CI 1.76-21.04; p<0.005). CONCLUSION: In preschool age children, when the daytime nap begins to disappear, snoring may have an effect on daytime schedule through an increased need for daytime sleep.
Subject(s)
Circadian Rhythm/physiology , Sleep/physiology , Snoring/physiopathology , Wakefulness/physiology , Adenoids/pathology , Attention Deficit Disorder with Hyperactivity/physiopathology , Case-Control Studies , Child , Child, Preschool , Disorders of Excessive Somnolence/physiopathology , Female , Humans , Hypertrophy , Male , Mouth Breathing/physiopathology , Palatine Tonsil/pathology , Sleep Apnea, Obstructive/physiopathology , Sleep Stages/physiology , Time FactorsABSTRACT
The aim of this study was to ascertain whether changes in the concentrations of cerebrospinal fluid excitatory amino acids (EAAs) contribute to neurotoxicity of the standard acute lymphoblastic leukaemia (ALL) treatment protocols. We found a statistically significant increase in glutamate and aspartate in 12 ALL patients during their treatment. Cognitive functioning was examined in all patients at an average of 3.7 years after the disease diagnosis. Importantly, the levels of EAAs during the therapy were not correlated with the results of the cognitive test. This study suggests that standard ALL treatment-induced neurotoxicity may not lead to persistent neurocognitive deficits.
