[Convulsions during treatment of acute lymphoblastic leukemia in children]. / Crisi convulsive durante il trattamento per leucemia linfoblastica acuta nel bambino.

BACKGROUND: The prevalence of seizures in children with acute lymphoblastic leukemia (ALL) varies between 3 and 13% depending on the various studies, whereas it is 1% in the general population aged under 15 years etiopathogenesis and outcome of seizures in children during treatment for ALL. METHODS: A retrospective study was carried out in 204 children with a consecutive diagnosis of ALL, 89 females and 115 males, aged between 5 months and 17 years and 11 months, diagnosed between 15-4-1988 and 15-4-1998, and treated at the Division of Pediatric Oncology and Pediatric Hematology of Turin University using three successive generations of AIEOP protocols 88 (48 cases), 91 (86 cases) and 95 (70 cases). Observation of the patients in the study ended on 30-9-1998. The criteria for eligibility were those stated in the respective protocols. Seizures were classified using the international classification; the diagnosis was made if a doctor, a nurse or a reliable relative witnessed the event with confirmation by the consultant neurologist. RESULTS: Twelve out of 204 (5.8%) patients in this series presented seizures: 2 out of 48 cases using protocol 88 (4.1%), 6 out of 86 cases using protocol 91 (6.9%) and 4 out of 70 cases using protocol 95 (5.7%). None of the patients had critical episodes or other significant neurological pathologies prior to the onset of ALL, nor had they been affected by leukemic meningosis or undergone cranial radiotherapy. When evaluating the possible etiology, the authors noted that, except for one case of febrile convulsion, the seizures in the remaining patients could be attributed to the toxicity of chemotherapy. With regard to the evolution of seizures, only one patient died, whereas the others showed no neurologic sequelae. CONCLUSIONS: The frequency of seizures in children receiving treatment for ALL in the series analysed here is in line with that reported in the literature. Neurotoxicity caused by chemotherapy appears to be the main etiopathogenetic factor.

[Polyamine evaluation in serum and erythrocytes of pediatric patients with neoplasms]. / Dosaggi plasmatici ed eritrocitari delle poliamine in pazienti oncologici pediatrici.

BACKGROUND: As previous studies demonstrated, free polyamines (putrescine, spermidine and spermine) are increased in neoplastic tissue and in body fluid (blood, urine and spinal fluid) of patients with tumours in various localization. In pediatric oncology, there aren't many specific markers useful to screen subjects at risk of developing cancer or to follow-up after treatment. For these reasons, polyamines' levels in plasma and erythrocytes have been evaluated in three groups of patients: healthy, with acute leukemia and with solid tumour. METHODS: Polyamines' content has been determined on samples of blood, previously dansylated, by HPLC (high performance liquid chromatography). RESULTS: The results of this study show that putrescine is decreased in plasma of patients with acute leukemia and with solid tumours. The difference, even if more important in subjects with leukemia, is significant in both groups. Spermidine instead, shows an increase, but only in patients with solid tumour. Erythrocyte assays reveal a significant decrease of spermidine in subjects with acute leukemia with consequent inversion of spermidine/spermine ratio. In erythrocytes there aren't any other significant changes in relation to the levels observed in healthy patients. Polyamine assay, especially that of putrescine and spermidine in plasma, could be propounded as a marker for pediatric neoplasms. CONCLUSIONS: Moreover, as it is well-known, pediatric neoplasms lead to alterations of polyamine metabolism, because the synthesis and catabolism of these molecules is closely involved in tumoral growth. Consequently, inhibitors of polyamine synthesis could be used with success in antineoplastic chemotherapy.