Abstract Objectives: To investigate the clinical and neuroimaging characteristics of leukoencephalopathy among children with acute lymphoblastic leukemia, especially after chemotherapy. Methods: Clinical data for 17 pediatric patients with leukoencephalopathy and 17 matched controls were retrospectively analyzed. All participants were children with acute lymphoblastic leukemia. The data mainly consisted of general information, laboratory studies, and imaging diagnostic results. Results: Overall, 94.12% of the patients experienced neurological symptoms. The most common symptoms were seizure (7/17, 41.18%), nausea (5/17, 29.41%), vomiting (5/17, 29.41%), paralysis (5/17, 29.41%), and numbness (4/17, 23.53%). On neuroimaging, multiple and irregular lesions were observed, distributed mainly in the periventricular area (9/17, 52.94%), parietal lobe (6/17, 35.29%), and basal ganglia (5/17, 29.41%). Moreover, there were significant differences in serum sodium (P = 0.0001), alanine transaminase (p = 0.0108), C-reactive protein (P = 0.0124), blood pressure (P = 0.0271), hemoglobin (P = 0.0273), platelets (P = 0.0421), and creatinine (P = 0.0458) between patients with and without leukoencephalopathy. After aggressive treatment, the clinical symptoms (12/17, 70.59%) and imaging lesions (11/13, 84.62%) gradually improved in most patients. Conclusion: Chemotherapy is an important risk factor related to leukoencephalopathy. Although the clinical symptoms of leukoencephalopathy vary widely, there is a high degree of consistency in its radiological features. Abnormal laboratory results may also help the identification of leukoencephalopathy. Early detection and treatment can improve brain development in the long term.
Keywords: leukoencephalopathy; clinical characteristics; chemotherapy; acute lymphoblastic leukemia; children.