22 de enero de 2012

Leucemia aguda linfoblástica. Alteraciones neuropsicológicas asociadas con profilaxis al sistema nervioso central

Pilar Lavielle, Etta Rozen, Héctor Avilés, Adolfo Hernández, Israel Grijalva

Rev Med IMSS 2004; 42 (2): 167-173


Objective: our objective was to determine the association between cognitive alterations and prophylactic treatment to the central nervous system (CNS). Material and methods: we evaluated, by means of a standardized neuropsychologic test, adults with diagnosis of acute leukemia who received prophylactic treatment to CNS, and patients with Hodgkin lymphoma as control group. Results: global evaluation of the neuropsychologic test in each group showed that 16.7 % of patients with acute leukemia and 13.3 % of patients with Hodgkin lymphoma obtained scores that exhibited slight cognitive damage (OR = 1.3, CI 95 % = 0.312-5.4). In partial evaluation of each cognitive ability, patients with ALL presented disturbances with greater frequency than the group with Hodgkin lymphoma (attention OR = 3, CI 95 % = 1.04-8.6; memory OR =1.8, CI 95 % = 0.61-5.2; and language OR = 2, CI 95 % = 0.7-5.67). Conclusions: patients who received prophylactic treatment to CNS presented some type of disturbance of the cognitive functions, with greater frequency than did patients who did not receive this treatment. Although it was not demonstrated that prophylaxis of CNS was associated with a specific neurologic syndrome, it was found associated with the disturbance of some of the functions, specifically with attention and concentration.