01 December 2025 : Review article
A Review of the Role of Neuroimaging in Neurotoxicity Monitoring in Children with Acute Lymphoblastic Leukemia
Agata Rocka
ABEF 1*, Łucja Justyna Walczak ABCEF 2, Wiktoria Herbut BEF 3, Maria Leśniak BEF 4, Patrycja Majka BCEF 4, Justyna Lipniarska BEF 4, Monika Lejman ABCDEF 5, Joanna Zawitkowska ABCDEF 6, Magdalena Maria Woźniak ABCDEF 1
DOI: 10.12659/MSM.948914
Med Sci Monit 2025; 31:e948914
Table 2 Case reports with neurological and systemic complications reported in association with vincristine-based chemotherapy regimens in ALL in children.
| No. | Diagnosis | Age | Sex | Treatment protocol | Neurological symptoms | Neuroimaging findings | Suspected drug | Rescue treatment |
|---|---|---|---|---|---|---|---|---|
| 1 | T-ALL []48 | 5y | M | MCP-841 protocol | Seizures | parieto-occipital and frontoparietal cortical/subcortical T2 hyperintensities with no evidence of diffusion restriction (PRES) | Prednisolone, vincristine, asparaginase, IT-MTX | Phenytoin |
| Altered sensorium | ||||||||
| Blurring of vision | ||||||||
| 2 | T-ALL []48 | 5y | M | Seizures | hyperintense in FLAIR along periventricular, parieto-occipital region (PRES) | Phenytoin | ||
| Altered sensorium | ||||||||
| Blurring of vision | ||||||||
| 3 | T-ALL []48 | 7y | F | Seizures | hyperintensity in left parieto-occipital region with diffusion restriction (PRES) | Phenytoin, antihypertensives (amlodipine) | ||
| Altered sensorium | ||||||||
| Blurring of vision | ||||||||
| Hypertension | ||||||||
| 4 | T-ALL []48 | 7y | M | Seizures | frontal and parietal hypodensities (PRES) | Antiepileptics and antihypertensives (amlodipine, atenolol, and prazosin) | ||
| Altered sensorium | ||||||||
| Blurring of vision | ||||||||
| Hypertension | ||||||||
| 5 | T-ALL []48 | 13y | M | Seizures | occipital lobe hypodensity suggestive of (PRES) | Antiepileptics | ||
| Altered sensorium | ||||||||
| Blurring of vision | ||||||||
| ALL – acute lymphocytic leukemia; F – female; FLAIR – fluid-attenuated inversion recovery (FLAIR); IT – intrathecal; M – male; MCP – Medical Council Protocol; MRI – magnetic resonance imaging; MTX – methotrexate; PRES – posterior reversible encephalopathy syndrome; T-ALL – T-cell acute lymphocytic leukemia; y – years. |