Structural brain alteration in survivors of acute lymphoblastic leukemia with chemotherapy treatment: A voxel-based morphometry and diffusion tensor imaging study.

OBJECTIVE: To assess structural brain changes in survivors of acute lymphoblastic leukemia (ALL) with chemotherapy treatment by combining voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS).

METHODS: 28 ALL patients (mean age: 40.71±8.58years, years since diagnosis: 7-38) and 20 age-matched control subjects (mean age: 42.95±6.39years) selected in this study with 3D T1 and diffusion tensor imaging acquired on a 3.0T Siemens MRI scanner. The ALL group had a history of chemotherapy treatment and off-therapy at least for 3years was enrolled. VBM and TBSS analysis were performed to detect regional grey matter (GM) volume changes and white matter (WM) alternation measured by fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD).

RESULTS: VBM revealed decreased GM volume in ALL patients in lingual gyrus, left occipital middle gyrus, left temporal middle gyrus, left postcentral gyrus, left parietal inferior gyrus, left precentral gyrus, left frontal superior gyrus and increased GM volume in right caudate and frontal lobe. WM integrity changes measured by TBSS which showed decreased FA and AD in several WM regions, and increased MD and RD in ALL patients with chemotherapy treatment.

CONCLUSION: Our results indicate that ALL patients had smaller GM volume and WM integrity changes in several regions. The current study may shed further light on the potential brain effects of chemotherapy treatment in ALL patients.