#Leukemia #ALL #AML #Infection #Sepsis #Neurocognition #Memory
Children diagnosed with acute lymphoblastic leukemia (ALL) or
acute
myeloid leukemia (AML) are particularly vulnerable to infections due to
aggressive treatments that weaken their
immune systems. Chemotherapy and
corticosteroids reduce natural defenses, while the use of
central venous
catheters increases the risk of bacterial and fungal infections.
Among these infections,
severe sepsis is one of the
most serious
complications. This excessive inflammatory response to an infection can lead to
multi-organ dysfunction, septic shock, and sometimes
death. Beyond endangering
patients’ lives, sepsis can also cause
treatment interruptions, increasing the
risk of
relapse.
While the immediate consequences of sepsis are well-documented, its
long-term effects on survivors of pediatric leukemia remain poorly understood.
Some studies suggest that patients who have survived severe sepsis may be at
higher risk of developing
chronic disorders.
This study aims to explore the link between
severe sepsis episodes
during leukemia treatment and complications in adulthood. The goal is to
identify potential
physical and cognitive sequelae to improve the management
and long-term medical follow-up of survivors.
Read next: ALL: a constantly evolving battle
Does Sepsis Leave a Mark on the Brain?
A total of
644 adult survivors of pediatric leukemia were included in
the study. Among them,
46 patients (7.1%) had experienced a severe sepsis
episode during their treatment. The study compared their health status in
adulthood with that of survivors who had not experienced sepsis. The risks of
chronic diseases affecting the
cardiovascular, pulmonary, renal, neurological,
and neurocognitive systems were evaluated.
The findings demonstrate that
severe sepsis does not increase the risk
of chronic diseases in the cardiovascular, pulmonary, renal, or neurological
systems. However, survivors who had sepsis
showed a significantly higher risk
of moderate to severe neurocognitive disorders (63% vs. 51.8%, p < 0.001).
These deficits primarily affect
attention, memory, executive functions, and
visuospatial abilities.
These results highlight a possible link between sepsis during cancer
treatment and
long-term cognitive sequelae in survivors of pediatric leukemia.
Read next: Sepsis: A Critical Challenge for Global Health
Sepsis and Memory: A Link Not to Be Forgotten!
Pediatric acute leukemia, whether
lymphoblastic or
myeloid, now benefits
from
effective treatments that have significantly improved survival rates.
However, these treatments
weaken the immune system, exposing patients to a
higher risk of
severe infections, including
sepsis, which can lead to
multi-organ dysfunction and complicate the therapeutic course.
While the immediate effects of
severe sepsis are well known, its
long-term impact on the health of pediatric leukemia survivors remains poorly
understood. Sepsis can cause damage to multiple organs, and some studies
suggest an
increased risk of neurocognitive sequelae in patients who have
survived a sepsis episode during treatment.
This study aims to
assess the relationship between severe sepsis and the
onset of chronic disorders in adulthood among survivors of pediatric leukemia,
particularly in terms of
neurocognitive function.
The results show that
severe sepsis during pediatric leukemia treatment
is associated with an increased risk of long-term neurocognitive deficits,
primarily affecting
attention, memory, and executive functions. However, it
does not increase the risk of major chronic diseases affecting the heart,
lungs, kidneys, or nervous system.
The study may be influenced by
survival bias, as only patients who
survived sepsis were analyzed. Additionally, the
exact mechanisms explaining
the impact of sepsis on cognitive disorders remain unclear, with other
contributing factors potentially playing a role. Further research is necessary
to better understand these links, identify
risk factors, and develop
prevention
strategies and early interventions for cognitive deficits to improve the
quality of life of pediatric leukemia survivors.
Read next: IVIG: an ally against fever in ALL?
