Neurotoxic Complications of Chemotherapy in Children. Literature Review

The article provides the review of literature on the issue of neurotoxic complications of chemotherapy in children. The data search was carried out in the PubMed, CyberLeninka, RSCI databases and others. There are many works devoted to studying the distribution, structure, and clinical features of chemo-induced neurological disorders in modern literature. In general, analysis of literature has shown that the incidence of neurotoxic complications varies widely depending on the research methods and used chemo-ther-apeutic drugs. Manifestations of chemotherapy-induced neurological disorders are quite diverse and accompanied by the central and peripheral nervous system damage. However, it has been shown that the platinum-based drugs have effective ototoxic effect with the damage of the auditory nerve. The Vincristine often causes peripheral polyneuropathy. Methotrexate and Ifosfamide cause metabolic encephalopathy. Cytarabine’s neurotoxicity is the damage of the cerebellum. The addition of neurological symptoms leads to decrease in the quality of life of patients. Some studies present the results of study of the causes and pathogenetic manifestations of neurotoxic reactions, changes in the genome associated with the development of specific toxic effects are identified. Despite the fact that many pathogenetic mechanisms of chemotherapy-induced neurotoxic complications have been revealed, the significance of laboratory predictors for prognosing and early assessment of these complications has not been essentially established yet, thus, there is the need for further study of this topic

Нейротоксические осложнения химиотерапии у детей. Обзор литературы

The article provides the review of literature on the issue of neurotoxic complications of chemotherapy in children. The data search was carried out in the PubMed, CyberLeninka, RSCI databases and others. There are many works devoted to studying the distribution, structure, and clinical features of chemo-induced neurological disorders in modern literature. In general, analysis of literature has shown that the incidence of neurotoxic complications varies widely depending on the research methods and used chemo-ther-apeutic drugs. Manifestations of chemotherapy-induced neurological disorders are quite diverse and accompanied by the central and peripheral nervous system damage. However, it has been shown that the platinum-based drugs have effective ototoxic effect with the damage of the auditory nerve. The Vincristine often causes peripheral polyneuropathy. Methotrexate and Ifosfamide cause metabolic encephalopathy. Cytarabine’s neurotoxicity is the damage of the cerebellum. The addition of neurological symptoms leads to decrease in the quality of life of patients. Some studies present the results of study of the causes and pathogenetic manifestations of neurotoxic reactions, changes in the genome associated with the development of specific toxic effects are identified. Despite the fact that many pathogenetic mechanisms of chemotherapy-induced neurotoxic complications have been revealed, the significance of laboratory predictors for prognosing and early assessment of these complications has not been essentially established yet, thus, there is the need for further study of this topic.В статье представлен обзор литературы по проблеме нейротоксических осложнений химиотерапии у детей, проведен поиск по базам данных PubMed, CyberLeninka, РИНЦ и др. В современной литературе много работ посвящено изучению распространения, структуры и клинической картины химиоиндуцированных неврологических расстройств. В целом анализ литературных источников показал, что частота встречаемости нейротоксических осложнений широко варьирует в зависимости от проводимых методов исследований и используемых химиотерапевтических препаратов. Проявления химиоиндуцированных неврологических расстройств достаточно разнообразны и сопровождаются поражением центральной и периферической нервной системы. Однако, показано, что препараты платины оказывают преимущественно ототоксическое действие с поражением слухового нерва. При лечении алкалоидами барвинка достаточно часто формируется периферическая полинейропатия. На фоне приема метотрексата и ифосфамида развивается метаболическая энцефалопатия. К основным проявлениям нейротоксичности препарата цитарабина относят поражение мозжечка. Присоединение неврологических симптомов снижает качество жизни пациентов, усугубляет течение основного заболевания и влияет на прогноз. В некоторых исследованиях представлены результаты изучения причин и патогенетических механизмов нейротоксических реакций, выявлены изменения генома, связанные с риском развития специфических токсических эффектов. Несмотря на то, что многие патогенетические механизмы химиоиндуцированных нейротоксических осложнений расшифрованы, значение лабораторных предикторов для прогнозирования и ранней оценки этих осложнений не установлено, что определяет направление дальнейшего изучения данной проблемы