Immune-mediated neurological syndromes associated with childhood cancers

Eur J Paediatr Neurol. 2024 Nov:53:174-181. doi: 10.1016/j.ejpn.2024.10.013. Epub 2024 Oct 31.

Abstract

The association of recognisable neurological conditions with an underlying malignancy is well described. In this review we explore the complex interplay of genetic, environmental and tumour factors which contribute to autoimmunity and paraneoplastic conditions. We review the current understanding of the pathogenesis of well recognised paraneoplastic conditions in children including Opsoclonus myoclonus ataxia syndrome, N-Methyl-D Aspartate receptor encephalitis and limbic encephalitis, and the broad approaches to treatment. Rapid advances in oncological treatment has expanded the arsenal of therapeutic modalities. We explore the broad spectrum of immune therapies in childhood cancer, and the potential neurological complications of these novel therapies, and discuss the fine balance of risk and benefit that these bring.

Keywords: Immune therapy; Neurological immune related adverse events; Paediatric neurology; Paediatric oncology; Paraneoplastic.

Publication types

  • Review

MeSH terms

  • Child
  • Humans
  • Neoplasms* / complications
  • Neoplasms* / immunology
  • Opsoclonus-Myoclonus Syndrome / etiology
  • Opsoclonus-Myoclonus Syndrome / immunology
  • Paraneoplastic Syndromes, Nervous System / immunology