Clinical characteristics and prognosis of acute B-lymphoblastic leukemia complicated with chemotherapy-induced peripheral neuropathy in children

Objective To summarize the characteristics of chemotherapy-induced peripheral neuropathy (CIPN) in children with acute B-lymphoblast leukemia (B-ALL) and to identify the influencing factors and prognosis of CIPN. Methods The clinical data of 60 children with B-ALL admitted to the 29th Ward of the Department of Hematology and Oncology, Children's Hospital Affiliated to Soochow University from June 2020 to December 2023 who received chemotherapy and had finished chemotherapy for 6 months were retrospectively reviewed. Results There were 37 cases of B-ALL combined with CIPN; the incidence of CIPN was 61.7%. Increasing age of onset was a risk factor for CIPN in children[OR= 1.209, 95% CI(1.023-1.428), P=0.026] with the highest incidence of sensory nerve dysfunction (78.4%). Electromyography indicated that B-ALL combined with CIPN was multiple peripheral neurogenic lesions with certain reversibility. In the induction stage of chemotherapy, 13 cases (35.1%) showed CIPN, accounting for the highest proportion. The CIPN improvement rate 6 months after chemotherapy was 67.6%, the age of onset[OR=2.418, 95% CI(0.212-2.106), P=0.018] and the severity of CIPN[OR=203.394, 95% CI(2.29-18 065.04). P=0.02] were risk factors for poor prognosis of children with CIPN. The older the age of onset was, the higher the severity of CIPN and worse prognosis were found. Conclusions Children with B-ALL complicated with CIPN are reversible multiple peripheral nerve lesions, and the occurrence and outcome of CIPN is potentially related to individual differences of children.