Cognitive Neurodynamics

, Volume 10, Issue 2, pp 185–188 | Cite as

Effect of high dose cytosine arabinoside on quantitative EEG in patients with acute myeloid leukemia

  • Marta Maschio
  • Francesco Marchesi
  • Sabrina Dispenza
  • Loredana Dinapoli
  • Francesca Sperati
  • Gianluca Petreri
  • Svitlana Gumenyuk
  • Maria Laura Dessanti
  • Alessia Zarabla
  • Tonino Cantelmi
  • Andrea Mengarelli
Brief Communication

Abstract

Background EEG activity is considered an index of functional state of brain. Chemotherapy (CT), used for non-central nervous system (CNS) cancer, can cross the blood brain barrier and contribute to changes in the functional state of brain that can alter background EEG activity. Quantitative EEG (qEEG) is superior to conventional EEG in the detection of subtle alterations of EEG background activity and for this reason, the use of qEEG might assist the clinician in evaluating the possible effect of CT on the CNS. The nucleoside analog cytosine arabinoside (Ara-C) is one of the milestone chemotherapeutic agents used for treatment of acute myeloid leukemia (AML). Our observational study evaluates the possible effect of Ara-C on the qEEG of patients with AML, without CNS involvement. We conducted an observational study on newly diagnosed AML patients without CNS involvement, undergoing treatment with Ara-C to analyze the possible effect of Ara-C high doses on EEG background activity using qEEG analyses. A total of nine AML patients, 5 with Ara-C i.v. high dose (≥3 g/m2 die), 4 with standard dose (100 mg/m2 die) underwent qEEG (at rest, during hyperpnoea, mental arithmetic task and blocking reaction). We compared the EEG background activity of the two groups at baseline and after 6 months. Statistical analysis showed no significant differences between the two groups in mean relative power for all frequency bands, at rest and during hyperpnoea, mental arithmetic task and blocking reaction. Our data indicate that high dose Ara-C i.v. did not induce significant changes on EEG background activity in our patients. Future research in this area could include prospective studies that would combine qEEG and neuropsychological testing to assess the impact of CT on brain functions.

Keywords

High dose cytosine arabinoside CNS qEEG Acute myeloid leukemia 

Notes

Acknowledgments

The Authors wish to thank Ms. Lesley Pritikin for reviewing the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Cho JR, Koo DL, Joo EY, Yoon SM, Ju E, Lee J, Kim DY, Hong SB (2012) Effect of levetiracetam monotherapy on background EEG activity and cognition in drug-naïve epilepsy patients. Clin Neurophysiol 123:883–891CrossRefPubMedGoogle Scholar
  2. Clemens B, Ménes A, Piros P, Bessenyei M, Altmann A, Jerney J, Kollar K, Rosdy B, Rozsavolgyi M, Steinecker K, Hollody K (2006) Quantitative EEG effects of carbamazepine, oxcarbazepine, valproate, lamotrigine, and possible clinical relevance of the findings. Epilepsy Res 70:190–199CrossRefPubMedGoogle Scholar
  3. Fitz-Gerald MJ, Patrick G (1991) Longitudinal quantitative EEG findings after acute carbon monoxide exposure: two case studies. Clin Electroencephalogr 22:217–224CrossRefPubMedGoogle Scholar
  4. John ER (1989) The role of quantitative EEG topographic mapping or ‘neurometrics’ in the diagnosis of psychiatric and neurological disorders: the pros. Electroencephalogr Clin Neurophysiol 73:2–4CrossRefPubMedGoogle Scholar
  5. Kadan-Lottick NS, Brouwers P, Breiger D, Kaleita T, Dziura J, Northrup V, Chen L, Nicoletti M, Bostrom B, Stork L, Neglia JP (2009) Comparison of neurocognitive functioning in children previously randomly assigned to intrathecal methotrexate compared with triple intrathecal therapy for the treatment of childhood acute lymphoblastic leukemia. J Clin Oncol 27:5986–5992CrossRefPubMedPubMedCentralGoogle Scholar
  6. Knott VJ (2000) Quantitative EEG methods and measures in human psychopharmacological research. Hum Psychopharmacol 15:479–498CrossRefPubMedGoogle Scholar
  7. Korinthenberg R, Schneider A, Niemeyer C (2002) Central nervous system prophylaxis with high-dose methotrexate does not give rise to significant electroencephalographic changes in children with acute lymphoblastic leukemia. J Child Neurol 17:409–412CrossRefPubMedGoogle Scholar
  8. Lazarus HM, Herzig RH, Herzig GP, Phillips GL, Roessmann U, Fishman DJ (1981) Central nervous system toxicity of high-dose systemic cytosine arabinoside. Cancer 48:2577–2582CrossRefPubMedGoogle Scholar
  9. Moleski M (2000) Neuropsychological, neuroanatomical, and neurophysiological consequences of CNS chemotherapy for acute lymphoblastic leukemia. Arch Clin Neuropsychol 15:603–630CrossRefPubMedGoogle Scholar
  10. Musha T, Mochiduki Y, Kurachi T, Matsuda H, Asada T (2004) Localization of impaired cortical neurons by EEG power fluctuation analysis. Int Congr Ser 1270:20–25CrossRefGoogle Scholar
  11. Nuwer MR (1988) Quantitative EEG: I. Techniques and problems of frequency analysis and topographic mapping. J Clin Neurophysiol 5:1–43CrossRefPubMedGoogle Scholar
  12. Russo D, Malagola M, de Vivo A, Fiacchini M, Martinelli G, Piccaluga PP, Damiani D, Candoni A, Michielutti A, Castelli M, Testoni N, Ottaviani E, Rondoni M, Pricolo G, Mazza P, Zuffa E, Zaccaria A, Raspadori D, Bocchia M, Lauria F, Bonini A, Avanzini P, Gugliotta L, Visani G, Fanin R, Baccarani M (2005) Multicenter phase III trial on fludarabine, cytarabine (Ara-C) and idarubicin, Ara-C and etoposide for induction treatment of younger newly diagnosed acute myeloid leukemia patients. Br J Haematol 131:172–179CrossRefPubMedGoogle Scholar
  13. Sainio K, Rautonen J, Ma Siimes (1989) Value of EEG in childhood acute lymphoblastic leukemia. Neuropediatrics 20:82–83CrossRefPubMedGoogle Scholar
  14. Ueberall MA, Haupt K, Hertzberg H, Langer T, Meier W, Huk WJ, Beck JD, Wenzel D (1996) Quantitative EEG in long term survivors of acute lymphoblastic leukemia. Pediatr Neurol 15:293–298CrossRefPubMedGoogle Scholar
  15. Veauthier J, Haettig H, Meencke HJ (2009) Impact of levetiracetam add-on therapy on different EEG occipital frequencies in epileptic patients. Seizure 18(6):392–395CrossRefPubMedGoogle Scholar
  16. Willemze R, Suciu S, Meloni G, Labar B, Marie JP, Halkes CJ, Muus P, Mistrik M, Amadori S, Specchia G, Fabbiano F, Nobile F, Sborgia M, Camera A, Selleslag DL, Lefrère F Sr, Magro D, Sica S, Cantore N, Beksac M, Berneman Z, Thomas X, Melillo L, Guimaraes JE, Leoni P, Luppi M, Mitra ME, Bron D, Fillet G, Marijt EW, Venditti A, Hagemeijer A, Mancini M, Jansen J, Cilloni D, Meert L, Fazi P, Vignetti M, Trisolini SM, Mandelli F, de Witte T (2014) High-dose cytarabine in induction treatment improves the outcome of adult patients younger than age 46 years with acute myeloid leukemia: results of the EORTC-GIMEMA AML-12 trial. J Clin Oncol 32:219–228CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Marta Maschio
    • 1
  • Francesco Marchesi
    • 2
  • Sabrina Dispenza
    • 1
  • Loredana Dinapoli
    • 1
  • Francesca Sperati
    • 3
  • Gianluca Petreri
    • 1
  • Svitlana Gumenyuk
    • 2
  • Maria Laura Dessanti
    • 2
  • Alessia Zarabla
    • 1
  • Tonino Cantelmi
    • 1
  • Andrea Mengarelli
    • 2
  1. 1.Center for Tumor-Related Epilepsy, Area of Supporting CareRegina Elena National Cancer InstituteRomeItaly
  2. 2.Hematology and Stem Cell Transplantation UnitRegina Elena National Cancer InstituteRomeItaly
  3. 3.Biostatistics/Scientific DirectionRegina Elena National Cancer InstituteRomeItaly

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