儿童急性淋巴细胞白血病诱导化疗期间合并可逆性后部脑2例并文献复习
Encephalopathy Syndrome in Children with Acute Lymphoblastic Leukemia after Induction Chemotherapy: 2 Cases Report and Literature Review
DOI: 10.12677/ACM.2023.1381787, PDF,   
作者: 徐 彤*, 姜 红#：青岛大学附属医院新生儿科，山东 青岛；仲 任：青岛大学附属医院儿童血液肿瘤科，山东 青岛
关键词: 可逆性后部脑；急性淋巴细胞白血病；诱发因素；儿童；Posterior Reversible Encephalopathy Syndrome； Acute Lymssphoblastic Leukaemia； Predisposing Factors； Children
摘要: 目的：可逆性后部脑(posterior reversible encephalopathy syndrome, PRES)是急性淋巴细胞白血病(acute lymphoblastic leukemia, ALL)治疗过程中的一种并发症，重点探讨该病可能的诱发因素及发病机制，临床上尽可能避免该病的发生。方法：回顾性分析2例ALL合并PRES患儿的临床、影像学资料、治疗及预后转归，并结合文献复习。结果：两例病例皆是在诱导化疗期间长春新碱(vincristine, VCR)联合泊沙康唑应用后发生PRES，同时伴有化疗期间感染及多次输血，预后都较好。结论：ALL化疗期间需严格把握输血指征，及时控制感染，规范使用丙种球蛋白及粒细胞集落刺激因子，尽量避免在使用VCR期间合用泊沙康唑，如必须使用，应关注血脂水平及便秘问题。
Abstract: Objective: Posterior reversible encephalopathy syndrome (PRES) is a complication in treating acute lymphoblastic leukaemia (ALL). The focus was on the possible predisposing factors and pathogene-sis of the disease and to avoid the occurrence of the disease in clinical practice. Methods: Summarize and analyze the clinical data of 2 cases of ALL combined with PRES and review relevant literature. Results: In both cases, PRES occurred after induction chemotherapy with vincristine (VCR) com-bined with posaconazole, accompanied by infection during chemotherapy and multiple blood transfusions, and the prognosis was improved. Conclusion: Strict control of blood transfusion indi-cations during ALL chemotherapy, timely control of infection, standardised use of gammaglobulin and granulocyte colony-stimulating factor, and avoiding the use of posaconazole in combination with VCR as much as possible, and if necessary, paying attention to lipid levels and constipation.
文章引用：徐彤, 仲任, 姜红. 儿童急性淋巴细胞白血病诱导化疗期间合并可逆性后部脑2例并文献复习[J]. 临床医学进展, 2023, 13(8): 12747-12752. https://doi.org/10.12677/ACM.2023.1381787

参考文献

[1] Norman, J.K., Parke, J.T., Wilson, D.A. and McNall-Knapp, R.Y. (2007) Reversible Posterior Leukoencephalopathy Syndrome in Children Undergoing Induction Therapy for Acute Lymphoblastic Leukemia. Pediatric Blood & Cancer, 49, 198-203. [Google Scholar] [CrossRef] [PubMed]
[2] Gupta, A., Swaroop, C., Rastogi, R., Garg, R. and Bakhshi, S. (2008) Simultaneous Occurrence of Posterior Reversible Leukoencephalopathy Syndrome in Two Cases of Childhood Acute Lymphoblastic Leukemia Induction Chemotherapy. Pediatric Hematology and Oncology, 25, 351-358. [Google Scholar] [CrossRef] [PubMed]
[3] Morris, E.B., Laningham, F.H., Sandlund, J.T. and Khan, R.B. (2007) Posterior Reversible Encephalopathy Syndrome in Children with Cancer. Pediatric Blood & Cancer, 48, 152-159. [Google Scholar] [CrossRef] [PubMed]
[4] Siebert, E., Bohner, G., Liebig, T., Endres, M. and Liman, T.G. (2017) Factors Associated with Fatal Outcome in Posterior Reversible Encephalopathy Syndrome: A Retrospective Analysis of the Berlin PRES Study. Journal of Neurology, 264, 237-242. [Google Scholar] [CrossRef] [PubMed]
[5] Hinchey, J., Chaves, C., Appignani, B., Breen, J., Pao, L., Wang, A., Pessin, M.S., Lamy, C., Mas, J.L. and Caplan, L.R. (1996) A Reversible Posterior Leukoencephalopathy Syndrome. The New England Journal of Medicine, 334, 494-500. [Google Scholar] [CrossRef] 
[6] Millichap, J.G. (2015) Posterior Reversible Encephalopathy Syndrome in ALL. Pediatric Neurology Briefs, 29, Article 56.
[7] Kanekiyo, T., Hara, J., Matsuda-Hashii, Y., Fujisaki, H., Tokimasa, S., Sawada, A., Kubota, K., Shimono, K., Imai, K. and Ozono, K. (2005) Tacrolimus-Related Encephalo-pathy following Allogeneic Stem Cell Transplantation in Children. International Journal of Hematology, 81, 264-268. [Google Scholar] [CrossRef] 
[8] Kim, S.J., Im, S.A., Lee, J.W., Chung, N.G., Cho, B., Kim, H.K. and Lee, I.G. (2012) Predisposing Factors of Posterior Reversible Encephalopathy Syndrome in Acute Childhood Leukemia. Pediatric Neurology, 47, 436-442. [Google Scholar] [CrossRef] [PubMed]
[9] Panis, B., Vlaar, A.M., van Well, G.T., Granzen, B., We-ber, J.W., Postma, A.A. and Klinkenberg, S. (2010) Posterior Reversible Encephalopathy Syndrome in Paediatric Leu-kaemia. European Journal of Pediatric Neurology, 14, 539-545. [Google Scholar] [CrossRef] [PubMed]
[10] Bartynski, W.S., Tan, H.P., Boardman, J.F., Shapiro, R. and Marsh, J.W. (2008) Posterior Reversible Encephalopathy Syndrome after Solid Organ Transplantation. American Journal of Neuroradiology, 29, 924-930. [Google Scholar] [CrossRef] 
[11] Bartynski, W.S., Zeigler, Z., Spearman, M.P., Lin, L., Shadduck, R.K. and Lister, J. (2001) Etiology of Cortical and White Matter Lesions in Cyclosporin-A and FK-506 Neurotoxicity. American Journal of Neuroradiology, 22, 1901-1914.
[12] Reinohs, M., Straube, T., Baum, P., Berrouschot, J. and Wagner, A. (2002) Recurrent Reversible Cerebral Edema after Long Term Immunosuppression with Tacrolimus. Journal of Neurol-ogy, 249, 780-781. [Google Scholar] [CrossRef] [PubMed]
[13] Tetsuka, S. and Ogawa, T. (2019) Posterior Reversible Encepha-lopathy Syndrome: A Review with Emphasis on Neuroimaging Characteristics. Journal of the Neurological Sciences, 404, 72-79. [Google Scholar] [CrossRef] [PubMed]
[14] Chan, J.D. (1998) Pharmacokinetic Drug Interactions of Vinca Alkaloids: Summary of Case Reports. Pharmacotherapy, 18, 1304-1307.
[15] Li, Y., Theuretzbacher, U., Clancy, C.J., Nguyen, M.H. and Derendorf, H. (2010) Pharmacokinetic/Pharmacodynamic Profile of Posaconazole. Clinical Pharmacokinetics, 49, 379-396. [Google Scholar] [CrossRef] [PubMed]
[16] Chen, L., Krekels, E.H.J., Verweij, P.E., Buil, J.B., Knibbe, C.A.J. and Brüggemann, R.J.M. (2020) Pharmacokinetics and Pharmacody-namics of Posaconazole. Drugs, 80, 671-695. [Google Scholar] [CrossRef] [PubMed]
[17] Khalil, H.A., ElKhatib, M.A.W., Belal, T.S., El-Yazbi, A.F. and Hamdy, D.A. (2017) Hyperlipidemia Alters the Pharmacokinetics of Posaconazole and Vincristine upon Co-Administration in Rats. Drugs in R & D, 17, 287-296. [Google Scholar] [CrossRef] [PubMed]
[18] Gao, B., Lyu, C., Lerner, A. and McKinney, A.M. (2018) Con-troversy of Posterior Reversible Encephalopathy Syndrome: What Have We Learnt in the Last 20 Years? Journal of Neurology, Neurosurgery, and Psychiatry, 89, 14-20. [Google Scholar] [CrossRef] [PubMed]
[19] Fugate, J.E. and Rabinstein, A.A. (2015) Posterior Reversible En-cephalopathy Syndrome: Clinical and Radiological Manifestations, Pathophysiology, and Outstanding Questions. The Lancet Neurology, 14, 914-925. [Google Scholar] [CrossRef] 
[20] Liman, T.G., Siebert, E. and Endres, M. (2019) Posterior Reversible Encephalopathy Syndrome. Current Opinion in Neurology, 32, 25-35. [Google Scholar] [CrossRef] 
[21] Fischer, M. and Schmutzhard, E. (2017) Posterior Reversi-ble Encephalopathy Syndrome. Journal of Neurology, 264, 1608-1616. [Google Scholar] [CrossRef] [PubMed]
[22] Singer, S., Grommes, C., Reiner, A.S., Rosenblum, M.K. and DeAngelis, L.M. (2015) Posterior Reversible Encephalopathy Syndrome in Patients with Cancer. The Oncologist, 20, 806-811. [Google Scholar] [CrossRef] [PubMed]
[23] Chen, Z., Shen, G.Q., Lerner, A. and Gao, B. (2017) Im-mune System Activation in the Pathogenesis of Posterior Reversible Encephalopathy Syndrome. Brain Research Bulletin, 131, 93-99. [Google Scholar] [CrossRef] [PubMed]
[24] Bartynski, W.S. and Boardman, J.F. (2008) Catheter Angi-ography, MR Angiography, and MR Perfusion in Posterior Reversible Encephalopathy Syndrome. American Journal of Neuroradiology, 29, 447-455. [Google Scholar] [CrossRef] 
[25] Datar, S., Singh, T.D., Fugate, J.E., Mandrekar, J., Rabinstein, A.A. and Hocker, S. (2015) Albuminocytologic Dissociation in Posterior Reversible Encephalopathy Syndrome. Mayo Clinic Proceedings, 90, 1366-1371. [Google Scholar] [CrossRef] [PubMed]
[26] Neeb, L., Hoekstra, J., Endres, M., Siegerink, B., Siebert, E. and Liman, T.G. (2016) Spectrum of Cerebral Spinal Fluid Findings in Patients with Posterior Reversible Encephalopa-thy Syndrome. Journal of Neurology, 263, 30-34. [Google Scholar] [CrossRef] [PubMed]
[27] Ellis, C.A., McClelland, A.C., Mohan, S., Kuo, E., Kasner, S.E., Zhang, C., Khankhanian, P. and Balu, R. (2019) Cerebrospinal Fluid in Posterior Reversible Encephalopathy Syndrome: Implications of Elevated Protein and Pleocytosis. The Neurohospitalist, 9, 58-64. [Google Scholar] [CrossRef] [PubMed]
[28] Liman, T.G., Bohner, G., Endres, M. and Siebert, E. (2014) Dis-charge Status and in-Hospital Mortality in Posterior Reversible Encephalopathy Syndrome. Acta Neurologica Scandina-vica, 130, 34-39. [Google Scholar] [CrossRef] [PubMed]

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