Neurotoxicity more likely in Hispanic children treated for acute lymphoblastic leukemia

A study of 280 patients with newly diagnosed pediatric acute lymphoblastic leukemia (ALL) found that Hispanics were more likely than non-Hispanic whites to develop neurotoxicity when they were treated with methotrexate chemotherapy. Moreover, the adverse response often required treatment modifications that, in turn, raised the risk of possible relapse. Fte findings were published recently in Clinical Cancer Research.1 fte most common pediatric cancer, ALL is often curable, with survival rates of approximately 90%. Children from minority populations, however, tend to fare worse than white patients and to experience lower cure rates, notes the study’s lead author Michael Scheurer, PhD, MPH, director of the Childhood Cancer Epidemiology and Prevention Program at Texas Children’s Cancer Center in Houston. To better understand neurotoxicity from methotrexate chemotherapy, a key treatment for ALL, researchers assessed patients from 3 pediatric cancer treatment centers between 2012 and 2017. ftey examined medical records for suspected neurotoxicity, which can include symptoms such as an altered mental status, seizures, and stroke-like problems. Findings showed that 39 patients (13.9%) had neurotoxicity reactions, with Hispanic patients experiencing neurotoxicity more than twice as often as non-Hispanic whites. Nine of those 39 patients, all Hispanic, also had a second neurotoxic event. Although other ethnic minority groups were included in the study, their numbers were too small to extrapolate any information on them. Scheurer and colleagues also found that patients who experienced neurotoxicity received less treatment. Specifically, they were given an average of 2.25 fewer doses of intrathecal methotrexate. Furthermore, 15.4% of patients who had neurotoxicity then had a relapse of their ALL, whereas just 2.1% of patients who did not experience neurotoxicity had a relapse of their disease. fte researchers are now investigating whether biomarkers may help to predict neurotoxicity.