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Review
. 2021 Jul 6;10(14):3016.
doi: 10.3390/jcm10143016.

Peripheral Nervous System Involvement in Non-Primary Pediatric Cancer: From Neurotoxicity to Possible Etiologies

Stefano Pro  1 , Luciana Vinti  2 , Alessandra Boni  3 , Angela Mastronuzzi  2 , Martina Scilipoti  4 , Margherita Velardi  5 , Anna Maria Caroleo  2 , Elisa Farina  3 , Fausto Badolato  5 , Iside Alessi  2 , Giovanni Di Nardo  5 , Andrea Carai  6 , Massimiliano Valeriani  1 , Antonino Reale  4 , Pasquale Parisi  5 , Umberto Raucci  4
Affiliations
Review

Peripheral Nervous System Involvement in Non-Primary Pediatric Cancer: From Neurotoxicity to Possible Etiologies

Stefano Pro et al. J Clin Med. .

Abstract

Peripheral neuropathy is a well described complication in children with cancer. Oncologists are generally well aware of the toxicity of the main agents, but fear the side effects of new drugs. As chemotherapeutic agents have been correlated with the activation of the immune system such as in Chemotherapy Induced Peripheral Neuropathy (CIPN), an abnormal response can lead to Autoimmune Peripheral Neuropathy (APN). Although less frequent but more severe, Radiation Induced Peripheral Neuropathy may be related to irreversible peripheral nervous system (PNS). Pediatric cancer patients also have a higher risk of entering a Pediatric Intensive Care Unit for complications related to therapy and disease. Injury to peripheral nerves is cumulative, and frequently, the additional stress of a malignancy and its therapy can unmask a subclinical neuropathy. Emerging risk factors for CIPN include treatment factors such as dose, duration and concurrent medication along with patient factors, namely age and inherited susceptibilities. The recent identification of individual genetic variations has advanced the understanding of physiopathological mechanisms and may direct future treatment approaches. More research is needed on pharmacological agents for the prevention or treatment of the condition as well as rehabilitation interventions, in order to allow for the simultaneous delivery of optimal cancer therapy and the mitigation of toxicity associated with pain and functional impairment. The aim of this paper is to review literature data regarding PNS complications in non-primary pediatric cancer.

Keywords: complications; pediatric cancer; peripheral nervous system; peripheral neuropathy.

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Conflict of interest statement

The authors declare that they have no potential conflict of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Cells and cytokines involved in chemotherapy damage (created by Biorender.com, accessed on 12 February 2021).
Figure 2
Figure 2
Immune checkpoint pathway PDL1: Programmed Death-Ligand 1; CTL-4: Cytotoxic T Lymphocyte Antigen 4; CD80: Cluster of Differentiation 80; MHC: Major Histocompatibility Complex; TCR: T Cell Receptor; PD1: Programmed Death 1 (Created by Biorender.com, accessed on 1 December 2020).
See this image and copyright information in PMC

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