Delayed neurotoxicity associated with therapy for children with acute lymphoblastic leukemia

Peter D. Cole, Barton A. Kamen

Research output: Contribution to journalReview articlepeer-review

67 Scopus citations


Most children diagnosed today with acute lymphoblastic leukemia (ALL) will be cured. However, treatment entails risk of neurotoxicity, causing deficits in neurocognitive function that can persist in the years after treatment is completed. Many of the components of leukemia therapy can contribute to adverse neurologic sequelae, including craniospinal irradiation, nucleoside analogs, corticosteroids, and antifolates. In this review, we describe the characteristic radiographic findings and neurocognitivie deficits seen among survivors of childhood ALL. We summarize what is known about the pathophysiology of delayed treatment-related neurotoxicity, with a focus on the toxicity resulting from pharmacologic disruption of folate physiology within the central nervous system. Finally, we suggest testable strategies to ameliorate the symptoms of treatment-related neurotoxicity or decrease its incidence.

Original languageEnglish (US)
Pages (from-to)174-183
Number of pages10
JournalMental Retardation and Developmental Disabilities Research Reviews
Issue number3
StatePublished - 2006
Externally publishedYes


  • Homocysteine
  • Leukoencephalopathy
  • Methotrexate
  • Neurotoxicity
  • S-adenosylmethionine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neuropsychology and Physiological Psychology
  • Genetics(clinical)


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