Central Nervous System Leukemia

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Despite routine presymptomatic CNS therapy in childhood leukemia, overt CNS relapses continue to occur in nearly 10 per cent of patients. Moreover, adverse sequelae of prophylactic CNS therapies continue to be observed, despite attempts at reduction in the preventive measures and to the extent that some subgroups of patients have suffered an increase in the incidence of overt CNS relapse. This review summarizes the historical events that led to presymptomatic treatments and the various methods that have been used to prevent and treat CNS relapse.

REFERENCES (107)

  • C.R. Pinkerton et al.

    Biopterin and neurotransmitter amine metabolism in children with acute lymphoblastic leukemia receiving methotrexate therapy

    J Pediatr

    (1986)
  • M.P. Sullivan et al.

    Combination intrathecal therapy for meningeal leukemia: Two versus three durgs

    Blood

    (1977)
  • M.P. Sullivan et al.

    Remission maintenance therapy for meningeal leukemia: Intrathecal methotrexate versus intravenous bis-nitrosourea

    Blood

    (1971)
  • M.P. Sullivan et al.

    Equivalence of intrathecal chemotherapy and radiotherapy as central nervous system prophylaxis in children with acute lymphatic leukemia: A Pediatric Oncology Group study

    Blood

    (1982)
  • R.D. Tallman et al.

    Assay for beta-glucuronidase in cerebrospinal fluid: Usefulness for the detection of neoplastic meningitis

    Mayo Clin Proc

    (1985)
  • H.T. Abelson et al.

    Intraventricular methotrexate therapy for central nervous system tumors

    Proc Am Assoc Cancer Res

    (1980)
  • R.J.A. Aur et al.

    A comparative study of central nervous system irradiation and intensive chemotherapy early in remission of childhood acute lymphocytic leukemia

    Cancer

    (1972)
  • F. Balis et al.

    Remission induction of meningeal leukemia with high dose intravenous methotrexate

    J Clin Oncol

    (1985)
  • M.J. Barnett et al.

    Central nervous system toxicity of high dose systemic cytosine arabinoside

    Semin Oncol

    (1985)
  • S.E. Bates et al.

    Ascending myelopathy after chemotherapy for central nervous system acute lymphoblastic leukemia: Correlation with cerebrospinal fluid myelin basic protein

    Med Pediatr Oncol

    (1985)
  • R.A. Berg et al.

    Neuropsychological sequelae of postradiation somnolence syndrome

    J Dev Behav Pediatr

    (1983)
  • W.A. Bleyer

    Central nervous system leukemia

  • W.A. Bleyer

    Intrathecal methotrexate versus central nervous system leukemia

    Cancer Drug Deliv

    (1984)
  • W.A. Bleyer

    Neurologic sequelae of methotrexate and ionizing radiation: A new classification

    Cancer Treat Rep

    (1981)
  • W.A. Bleyer et al.

    Reduction in central nervous system leukemia with a pharmacokinetically derived intrathecal methotrexate dosage regimen

    J Clin Oncol

    (1983)
  • W.A. Bleyer et al.

    White matter necrosis, mineralizing microangiopathy, and intellectual abilities in survivors of childhood leukemia: Associations with central nervous system irradiation and methotrexate therapy

  • W.A. Bleyer et al.

    Intraventricular versus intralumbar methotrexate for central-nervous-system leukemia

    Med Pediatr Oncol

    (1979)
  • W.P. Bowman et al.

    New directions of St. Jude Total-Therapy Protocols: Study X for standard-risk childhood acute lymphoblastic leukemia

  • P. Brouwers et al.

    Central nervous system preventive therapy with systemic high dose methotrexate versus cranial radiation and intrathecal methotrexate: Longitudinal comparison of effects of treatment on intellectual function of children with acute lymphoblastic leukemia (abstr)

    Proc Am Soc Clin Oncol

    (1987)
  • P. Brouwers et al.

    Central nervous system preventive therapy with systemic high dose methotrexate versus cranial radiation and intrathecal methotrexate: Comparison of effects of treatment on academic achievement in children with acute lymphoblastic leukemia (abstr)

    Proc Am Soc Clin Oncol

    (1988)
  • J.H. Burchenal

    History of intrathecal prophylaxis and therapy of meningeal leukemia

    Cancer Drug Deliv

    (1983)
  • M. Carli et al.

    Risk factors in long-term sequelae of central nervous system prophylaxis in successfully treated children with acute lymphocytic leukemia

    Med Pediatr Oncol

    (1985)
  • M. Casteels-van Daele et al.

    Acute encephalopathy after initiation of cranial irradiation for meningeal leukemia

    Lancet

    (1978)
  • J.M. Chessells et al.

    Methotrexate, cranial irradiation and neurotoxicity in childhood acute lymphoblastic leukaemia

    Proc Int Soc Pediatr Oncol

    (1987)
  • L. Ch’ien et al.

    Long-term neurological implications of somnolence syndrome in children with acute lymphocytic leukemia

    Ann Neurol

    (1980)
  • L.A. Clavell et al.

    Four-agent induction and intensive asparaginase therapy for treatment of childhood acute lymphoblastic leukemia

    N Engl J Med

    (1986)
  • C.J. Crosley et al.

    Central nervous system lesions in childhood leukemia

    Neurology

    (1978)
  • J.F. Dartigues et al.

    Manifestations neurologiques centrales au cours de la leucemie lymphoide chronique

    Bordeaux

    (1979)
  • P.D. Duffner et al.

    CT abnormalities and altered methotrexate clearance in children with CNS leukemia

    Neurology

    (1984)
  • S.F. Dunton et al.

    Progressive ascending paralysis following administration of intrathecal and intraveous cytosine arabinoside

    Cancer

    (1986)
  • M.J. Duttera et al.

    Irradiation, methotrexate toxicity, and the treatment of meningeal leukemia

    Lancet

    (1973)
  • A.E. Evans et al.

    The increasing incidence of central nervous system leukemia in children

    Cancer

    (1970)
  • J. Fallovollita et al.

    Intellectual dysfunction after cranial irradiation in young children with acute lymphoblastic leukemia: Concurrent intrathecal methotrexate is a contributing factor (abstr)

    Proc Am Soc Clin Oncol

    (1987)
  • L.S. Frankel et al.

    The curative potential of CNS relapse in childhood acute lymphocytic leukemia

    Proc Am Soc Clin Oncol

    (1982)
  • L.S. Frankel et al.

    High-dose intravenous methotrexate with an intrathecal methotrexate boost in the maintenance of ALL in children: A pilor study

    Proc Am Assoc Cancer Res

    (1980)
  • A.I. Freeman et al.

    Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children

    N Engl J Med

    (1983)
  • J.E. Freeman et al.

    Somnolence after prophylactic cranial irradiation in children with acute lymphoblastic leukemia

    Br Med J

    (1973)
  • J. Frick et al.

    Successful treatment of meningeal leukemia using systemic high-dose cytosine arabinoside

    J Clin Oncol

    (1984)
  • R.G. Gagliano et al.

    Paraplegia following intrathecal methotrexate: Report of a case and review of the literature

    Cancer

    (1976)
  • S. Garwicz et al.

    Postirradiation syndrome and EEG findings in children with acute lymphoblastic leukemia

    Acta Peditar Scand

    (1975)
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