Original ArticlesPosterior Reversible Encephalopathy Syndrome: Incidence and Clinical Characteristics in Children With CancerSommers, Katherine R.*; Skiles, Jodi MD, MS†; Leland, Brian MD‡; Rowan, Courtney M. MD, MSCR‡ Author Information *Indiana University School of Medicine †Department of Pediatrics, Division of Hematology/Oncology ‡Department of Pediatrics, Division of Critical Care, Indiana University School of Medicine, Indianapolis, IN This project was funded, in part, with support from the Indiana Clinical and Translational Sciences Institute funded, in part by UL1TR002529 from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflict of interest. Reprints: Katherine R. Sommers, 503 Round Hill Road, Indianapolis, IN 46260 (e-mail: [email protected]). Journal of Pediatric Hematology/Oncology: March 2022 - Volume 44 - Issue 2 - p 54-59 doi: 10.1097/MPH.0000000000002153 Buy Metrics Abstract The etiology and outcomes of posterior reversible encephalopathy syndrome (PRES) in children with cancer are not well understood. We aim to determine the incidence of PRES, describe associated morbidity and mortality, and better understand risk factors in this patient population. A total of 473 children with a hematologic malignancy or postallogeneic hematopoietic cell transplantation between June 2015 and June 2020 were screened for PRES to determine incidence and whether age or underlying diagnosis are associated with development of PRES. We conducted a case-control study to evaluate whether comorbidities or chemotherapeutic agents are associated with PRES. Children with PRES were matched with 2 controls based on age and underlying diagnosis to identify additional risk factors. Fourteen patients developed PRES, with an incidence of 5.9/1000 people/year. Those diagnosed with PRES had commonly described PRES symptoms: hypertension, seizures, nausea/vomiting, altered mental status, and headaches. All patients received an magnetic resonance imaging, and most had findings consistent with PRES. Hematopoietic cell transplantation was associated with the development of PRES. The use of Etoposide was associated with PRES but comorbidities, steroids and calcineurin inhibitors were not. While PRES was infrequent in this population, it is associated with high morbidity and mortality, with ICU admissions and an overall hospital mortality, because of secondary causes, of 29%. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.