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Neuroanatomical abnormalities related to dexamethasone exposure in survivors of childhood acute lymphoblastic leukemia.

Authors:
Nicholas S Phillips Yin Ting Cheung John O Glass Matthew A Scoggins Wei Liu Robert J Ogg Daniel A Mulrooney Ching-Hon Pui Leslie L Robison Wilburn E Reddick Melissa M Hudson Kevin R Krull

Pediatr Blood Cancer 2020 03 12;67(3):e27968. Epub 2019 Aug 12.

Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.

Survivors of childhood acute lymphoblastic leukemia (ALL) treated with chemotherapy only are at risk for neurocognitive impairment. Regions of interest were identified a priori based on glucocorticoid receptor distribution, and sex-stratified multivariable linear regression models were used to test associations between brain MRI morphology and total number of intrathecal injections, and serum concentration of dexamethasone and methotrexate. Compared with controls, ALL survivors have persistently smaller volumes in the bilateral cerebellum (P < 0.005), hippocampal subregions (P < 0.03), temporal lobe regions (P < 0.03), frontal lobe regions (P < 0.04), and parietal lobe regions (precuneus; P < 0.002). Long-term problems with learning may be related to residual posttreatment brain differences.

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http://dx.doi.org/10.1002/pbc.27968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6980878PMC
March 2020

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