Abstracts

Rationale: The 5-year survival rate of leukemia patients is 80% or more, and 8-10% of these patients develops seizures. Nevertheless, there are limited studies on children with epilepsy and hematologic malignancy. This study was designed to assess the incidence of epilepsy and the response to antiepileptic drugs (AEDs) in children with epilepsy and hematologic malignancy. Methods: This study included 32 patients (24 males and 8 females) who were treated with AEDs for at least more than one year and evaluated systemically thorough neurological examination, brain MRI and EEG. They were chosen from 1,040 children under 17 years of age with hematologic malignancy who visited to the pediatric neurology and pediatric hemato-oncology clinic of Seoul St. Mary's Hospital, from January 2009 to December 2016. The assessment of the response to AED treatment was based on the frequency of seizures after treatment.To evaluate the association between risk factors and the response to AED treatment, we examined the following risk factors: gender, age at the time of malignancy diagnosis, status of diagnosis, duration from malignancy diagnosis to epilepsy diagnosis, number of used AEDs, the involvement of the nervous system, types of epilepsy, EEG and brain MRI. Results: The mean ages at the time of diagnosis of hematologic malignancy and epilepsy were 6.5±2 years and 7.3±5 years, respectively. The incidence of epilepsy in children with hematologic malignancy was 4.2% and acute lymphoblastic leukemia was the most common type (8.4%) of hematologic malignancy.The percent of patients who had abnormal MRI finding and abnormal EEG were 84.4%(n=27) and 75.0%(n=24), respectively; however, the association of MRI and EEG with risk factors and the response to AED treatment was found to be not statistically significant. However, the relative risk of poor response to AED treatment in patients who were diagnosed with hematologic malignancy under 2 years of age was 2.1fold greater than in those who were diagnosed after 2 years of age (P=0.015). Conclusions: Although the incidence of epilepsy in children with hematologic malignancy is much higher than in the general population, most patients could respond well to AED treatment. However, further studies are necessary to confirm our findings. Funding: None