Breaking News
April 24, 2018 - Study sheds new light on how bilinguals process language
April 24, 2018 - Probiotics can improve liver health, shows study
April 24, 2018 - Study may explain how chemoresistance evolves over time in some triple-negative breast cancers
April 24, 2018 - Role of midbrain in encoding identity errors
April 23, 2018 - Salamander study provides clues for treating spinal cord injuries
April 23, 2018 - Relaxation after work could give better night’s sleep
April 23, 2018 - Loneliness on its way to becoming Britain’s most lethal condition
April 23, 2018 - Low-cost blood test for multiple myeloma can deliver same diagnostic information as bone biopsy
April 23, 2018 - Metabolic differences may contribute to postpartum weight retention in black moms
April 23, 2018 - Time-Related Deployment Factors Predict Suicide Attempt Risk
April 23, 2018 - Are newborns ugly? Research says newborns rated ‘less cute’ than older babies
April 23, 2018 - Prenatal marijuana use linked to increased chance of low birth weights
April 23, 2018 - Researchers identify target gene in P. aeruginosa infection
April 23, 2018 - New studies related to causes of liver degradation and possible treatments
April 23, 2018 - Studies offer leads for new approaches to treat neurological problems
April 23, 2018 - Gene Therapy May Be Cure for Some With Rare Blood Disorder
April 23, 2018 - Obesity impacts liver health in kids as young as eight years old
April 23, 2018 - Frequent cannabis use by young people linked to small reductions in cognitive function
April 23, 2018 - Innovative research could lead to new ways to treat, prevent cancer
April 23, 2018 - Study uncovers possible source of gender differences in migraines
April 23, 2018 - Study proves usefulness of EDX testing in diagnosis, management of neuromuscular disorders
April 23, 2018 - Hacking ‘drug trafficking’ system could increase effectiveness of diabetes treatment
April 23, 2018 - Clinical trial to examine stem cell therapy for treatment, prevention of complications after traumatic injury
April 23, 2018 - Targeted radiotherapy found to be a good option for women with early breast cancer
April 23, 2018 - Eating fish could prevent Parkinson’s disease
April 23, 2018 - Philips showcases dedicated radiation oncology solutions at ESTRO 2018
April 23, 2018 - Key factor in development of Parkinson’s disease identified
April 23, 2018 - Higher consumption of fish linked to better neurological health
April 23, 2018 - Genevac announces HT Series 3 evaporators with Inert Gas Purge option
April 23, 2018 - Researchers clarify immune response for patients with breast cancer brain metastases
April 23, 2018 - Polypharmacy More Likely for Cancer Survivors
April 23, 2018 - Obesity is shifting cancer to young adults
April 23, 2018 - Scientists illustrate role of novel chromosomal mutations in fosfomycin resistance
April 23, 2018 - Newly developed drug compound may help treat Charcot-Marie-Tooth disease
April 23, 2018 - Marriage Means ‘I Do’ for Skin Cancer Detection
April 23, 2018 - Freezing hunger-signaling nerve may help ignite weight loss
April 23, 2018 - Wear exoskeletons with caution for heavy lifting, researchers say
April 23, 2018 - Research offers new hope for healing wounds in patients with diabetes
April 23, 2018 - Shorter courses of radiotherapy found to be safe, effective for prostate cancer patients
April 23, 2018 - Scientists use CRISPR tool to make multiple edits to DNA samples ‘in vitro’
April 23, 2018 - Knee reconstructions are on the rise among the youth in Australia
April 23, 2018 - Artificial sweeteners linked to obesity warn researchers
April 23, 2018 - CDC seeking $400 million to replace lab for deadliest germs
April 23, 2018 - Sensirion to present single-use liquid flow sensor at COMPAMED 2017
April 23, 2018 - FDA approves contact lenses that shade the sun
April 22, 2018 - Concussion recovery and symptom severity found to vary between men and women
April 22, 2018 - C. Difficile Risk Higher With Stoma Reversal Versus Colectomy
April 22, 2018 - Repeated ranibizumab doesn’t impair macular perfusion
April 22, 2018 - New microscope reveals how cells behave in 3D and real time inside living organisms
April 22, 2018 - Study shows clinical benefit and monetary gains of weight-loss surgery
April 22, 2018 - GNA Biosolutions launches world’s first Laser PCR platform at Medica Trade Fair
April 22, 2018 - Researchers present simulation model to investigate hospital responsiveness to mass casualty incidents
April 22, 2018 - Does Pot Really Dull a Teen’s Brain?
April 22, 2018 - Controversial pregnancy test drug shows deformities in zebrafish embryos within hours of exposure
April 22, 2018 - New research partnership makes childbirth safer in Mozambique
April 22, 2018 - Brief bedside visual art intervention reduces pain, anxiety in cancer patients
April 22, 2018 - The memory part of the brain may also hold clues for anxiety and depression
April 22, 2018 - AYOXXA to develop multiplex immunoassay to support treatment of sepsis patients
April 22, 2018 - New Drug Combo Ups Survival in HER2/neu Uterine Serous Cancer
April 22, 2018 - Researchers chart a new way to look at concussion
April 22, 2018 - Every parent needs to know fundamental red flags for autism
April 22, 2018 - Anatotemp expands anatomic dental implant healing abutments with 4Side anti-rotational connection
April 22, 2018 - Gene Twist Can Make Your Blood Pressure Spike From Salt
April 22, 2018 - Study suggests failed osteoarthritis drug could help treat opioid addiction
April 22, 2018 - More Americans aware of growing problem of opioid addiction
April 22, 2018 - KHN’s ‘What the Health?’ Nothing in health care ever goes away
April 22, 2018 - BGS to promote high-quality sterilization services at Health GB in Manchester
April 22, 2018 - New integrated POC tool detects biomarkers of heart failure rapidly and precisely
April 22, 2018 - Direct electrical current can be delivered to nerves for blocking pain signals
April 22, 2018 - Newly Published Phase 2 Study Found Esketamine Demonstrated Significantly Rapid Improvements in Depressive Symptoms and Suicidality
April 22, 2018 - Healthy red blood cells owe their shape to muscle-like structures
April 22, 2018 - Researchers present case study of management of rheumatic mitral regurgitation in woman contemplating pregnancy
April 22, 2018 - New black Porvair Krystal UV Quartz microplates for Circular Dichroism measurements
April 22, 2018 - Advanced flow chemistry modules enhance control of nanoprecipitation
April 22, 2018 - Look! Down in the petri dish! It’s a superplatelet!
April 22, 2018 - Research reveals why people with tetraplegia more likely to suffer from sleep apnea
April 21, 2018 - New non-invasive nerve stimulation may offer relief for people with hand tremor
April 21, 2018 - Smartphone App May Up Medication Adherence in HTN
April 21, 2018 - Western diet depletes artery-protecting immune cells
April 21, 2018 - Excelitas Technologies launches new powerful LED light source for fluorescence microscopy
Leukemia itself may increase risk for long-term neurocognitive problems in survivors

Leukemia itself may increase risk for long-term neurocognitive problems in survivors

image_pdfDownload PDFimage_print

Leukemia itself, not just side effects related to its treatment, may increase the risk for long-term problems with attention, organization and related neurocognitive skills in survivors of the most common childhood cancer, according to research from St. Jude Children’s Research Hospital. The study appears today in the journal JAMA Oncology.

Researchers analyzed the cerebrospinal fluid (CSF) of 235 St. Jude pediatric acute lymphoblastic leukemia patients treated with chemotherapy alone. The group included 138 long-term survivors who participated in the study. Even before treatment began, some patients had proteins in their CSF that suggested injury to cells that make up the white matter in the brain. These are glial cells that help the brain function efficiently by insulating and supporting the neurons.

“This was a surprise. Until now, we had not suspected that leukemia, by itself, or the inflammatory response to the disease, may lead to changes that leave ALL survivors at risk for problems with executive functioning and processing speed later,” said corresponding author Kevin Krull, Ph.D., a member of the St. Jude Department of Epidemiology and Cancer Control.

Thirty to 40 percent of childhood leukemia survivors treated with chemotherapy alone develop neurocognitive problems. Researchers had assumed the problems were a side effect of therapy, particularly treatment with the chemotherapy agent methotrexate. So finding elevated biomarkers in the CSF of some patients during methotrexate treatment was not unexpected, but previously, little was known about the neurotoxic mechanism involved. The biomarkers identified were indicative of injury to neurons, axons and glial cells.

Researchers also found evidence that genetic variation may influence patients’ vulnerability to such treatment-related neurocognitive problems.

“Taken together, the results suggest that survivors’ neurocognitive deficits are multifactorial and reflect a complex interaction among genetics, treatment intensity and other factors,” Krull said. “Monitoring CSF biomarkers and screening for genetic mediators of brain injury may help identify and intervene with survivors at risk for neurocognitive problems.”

For this study, Krull and his colleagues analyzed CSF that had been collected from 235 patients at five times before and during treatment. The CSF was originally collected to monitor patients’ response to treatment and check for relapse.

The patients were enrolled in the Total XV St. Jude clinical trial. Their CSF was collected between 2000 and 2010. The analysis included neurocognitive testing and brain imaging of 138 survivors who were at least 8 years old and five years from their cancer diagnosis.

The researchers checked patients’ CSF for five proteins and other biomarkers of brain cell damage related to treatment with either high-dose intravenous methotrexate or methotrexate delivered into

the spinal fluid (intrathecal delivery). The biomarkers were present early in therapy, but changed and varied throughout treatment. For example, biomarkers of demyelination were present in some patients newly diagnosed with ALL and then decreased during treatment. Others, including biomarkers of inflammation and neuronal damage, were detected and increased as treatment progressed.

Overall, methotrexate treatment was associated with biomarkers that signaled as much as a 70 percent increased risk for reduced neurocognitive functioning as long-term survivors.

Researchers also checked for evidence that genetic variation may influence the susceptibility of pediatric ALL patients to methotrexate injury. Investigators checked patients’ DNA for 42 different gene variants known to influence drug metabolism, neurodevelopment and oxidative stress, which can damage cells.

The analysis identified a variant of the COMT gene that was associated with higher biomarker levels following methotrexate treatment. The gene encodes instructions for a protein involved in processing the neurotransmitter dopamine in the frontal regions of the brain.

“Dopamine is the primary neurotransmitter in executive functioning,” Krull said. “This suggests that two independent processes might be coming together in some patients that influence their risk for diminished executive functioning.”

Source:

https://www.stjude.org/media-resources/news-releases/2018-medicine-science-news/neurocognitive-risk-may-begin-before-treatment-for-young-leukemia-patients.html

About author

Related Articles