Abstract
The article presents an assessment of the neurotoxicity of chemotherapy in children with acute lymphoblastic leukemia receiving specific treatment according to the protocols used in pediatric oncological practice. An analysis of the neurological state with the determination of the chemokine profile of blood plasma was performed in 21 children aged 3 to 17 at the Regional Children’s Clinical Hospital in Yekaterinburg and the Central Research Laboratory of the Ural State Medical University in 2019. In the study group of children, neurotoxic complications were recorded in 42.9% of cases. At the same time, the appearance of neurological symptoms in most patients (77.7%) was observed during co chemotherapy at the stages of reinduction during consolidating treatment with a predominant clinical picture of chemo-induced polyneuropathy. In a comparative analysis of the indicators of the chemokine profile in groups of children, depending on the formation of neurotoxic complications during chemotherapy, we selected the chemokines CXCL10 (IP-10) and CXCL12 (SDF-1α) as possible prognostic biomarkers of damage to the nervous system.
Highlights
Hemoblastoses are one of the urgent problems of modern oncohematology
In the study group there were 21 children with a diagnosis of acute lymphoblastic leukemia (ALL), which was established on the basis of generally accepted methods
All children received chemotherapy according to the protocol
Summary
Hemoblastoses are one of the urgent problems of modern oncohematology. According to world statistics, the frequency of this pathology at children under the age of 15 years is 3.3 4.7 per 100 thousand child population. Modern methods for the treatment of hemoblastoses have improved the prognosis significantly, the 5-year survival rate presently is over 90% [1]. The use of chemotherapy is accompanied by a high frequency of drug complications, including those associated with neurotoxicity. The modern concept of the pathogenesis toxicity chemotherapeutic drugs is based on several types of effects on the nervous system: direct neurotoxicity, immune-mediated response and DNA damage [7,8,9,10,11]. The issues of standardization of the management of such patients remain unresolved, the values of laboratory markers for predicting and early diagnosis of neurotoxic complications have not been determined, which defines the direction for further study of this problem
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