Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Background and objectives: Central nervous system (CNS) complications are heterogeneous, varying from very mild and transient symptoms to extremely severe and debilitating or even lethal syndromes. The study aimed to assess the incidence, risk factors, patterns, and outcomes of different CNS complications during treatment of pediatric acute lymphoblastic leukemia (ALL). Patients and methods: A retrospective study included 390 patients with pediatric ALL, treated according to St. Jude total XV protocol at National Cancer Institute, Cairo University between January 2012 to December 2017. Results: As regards the incidence of CNS complications, there were 39 (10%) patients diagnosed with different types of CNS complications. Among those patients, there were 19 (4.9%) patients diagnosed with cerebrovascular complications, 12 (3.1%) patients diagnosed with posterior reversible encephalopathy syndrome (PRES), and 6 (1.5%) patients diagnosed with leukoencephalopathy, Both CNS infections and leukemic infiltrates were diagnosed in one patient each. As for predictive factors of the incidence, CNS complications were significantly higher in patients older than 10 years old, in patients with initial high-risk disease, and in patients who were classified as CNS III status. As for the outcome of patients with CNS complications, there were 31 (79.5%) cases achieved complete recovery, 6 (15.4%) patients died, and 2 (5.1%) patients developed residual neurological deficits

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