Leukemia (cancer of the blood)
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Chemotherapy
[Media UK, 1998] Leukaemia boy,11, dies after a final kiss from mother
Drugs used: vincristine, prednisone, doxorubicin, cyclophosphamide, cytarabine
Di Mario FJ Jr 1990), Packer RJ Pediatrics 1990 Mar 85:3 353-60. Acute
mental status changes in children with systemic cancer.
Acute changes in mental status (AMS) develop in children with
cancer from a multitude of cancer- and treatment-related complications. To determine the
incidence, etiology, and outcome of children with cancer who had AMS, the medical records
of all children under 18 years of age with systemic cancer (excluding primary central
nervous system tumors) who had AMS in our institution during the years 1981 through 1987
were reviewed. AMS developed in 89 of 815 children at risk (11%). The AMS was caused by
seizures in 53 (60%), an encephalopathy in 24 (27%), and a stroke syndrome in 12 (13%).
AMS occurred in 42 of 305 (14%) with leukemia, 16 of 139 (12%) with lymphoma, 14 of 136
(10%) with sarcoma, 10 of 104 (9%) with neuroblastoma, and 7 of 104 (5%) with other
malignancies. Children with acute lymphocytic leukemia were more prone to having seizures
(61%), while children with nonacute lymphocytic leukemia were almost equally likely to
have encephalopathies, strokes, or seizures. Children with lymphoma were admitted for
treatment most often with an encephalopathy (44%). Etiologies for AMS were evaluated
vigorously, and one or more etiologies were identified in 80 of 89 (89%) patients.
Dependent on the type of tumor, the anticancer treatment used and, timing during the
course of illness AMS occurred, specific diagnoses were more likely. Neurologic morbidity
and mortality were dependent on the cause of AMS. Children with seizures that were
initially difficult to control were more likely to require long-term anticonvulsant
therapy.
St Judes