Erschienen in:
Open Access
28.04.2020 | Original Article – Clinical Oncology
Long-term small-fiber neuropathy and pain sensitization in survivors of pediatric acute lymphoblastic leukemia after stem cell transplantation
verfasst von:
Victoria Ruscher, Sascha Lieber, Jörn-Sven Kühl, Johannes Schulte, Markus Blankenburg, Tobias Reindl, Pablo Hernáiz Driever
Erschienen in:
Journal of Cancer Research and Clinical Oncology
|
Ausgabe 8/2020
Einloggen, um Zugang zu erhalten
Abstract
Purpose
We aimed at describing for the first time peripheral small-fiber neurotoxicity and pain sensitization in survivors of pediatric acute lymphoblastic leukemia after stem cell transplantation (SCT).
Methods
In a cross-sectional, retrospective, single-center study, we assessed 25 relapse-free long-term survivors (median age at SCT: 11 ± 4.9 years; median time between SCT and testing: 8.25 years, 19 males) using a reduced version of the pediatric-modified total neuropathy score for clinical assessment and Quantitative Sensory Testing (QST). Inclusion criteria: \(\ge\) 6 years old at testing, \(\le\) 18 years old at time of SCT, \(\ge\) 1 year between SCT and testing.
Results
Nine patients (36%) had peripheral neuropathy as defined by the clinical red-pmTNS (≥ 4). The QST parameters mechanical pain sensitivity, mechanical detection threshold, thermal sensory limen, vibration detection threshold and pressure pain threshold were significantly abnormal in the survivor cohort (p < 0.0038). Except for one, all survivors showed at least one abnormal QST parameter. When using QST, signs of small and large fiber dysfunction were present in 22 (88%) and 17 (68%) survivors, respectively. More than half of all survivors were found to experience pathologic sensitization to pain.
Conclusions and implications for cancer survivors
Survivors of pediatric acute lymphoblastic leukemia after SCT are at high risk for long-term peripheral neuropathy with a dominating small-fiber and pain sensitization pattern.