Comparison of Two Methods of Preventing Central Nervous System Leukemia

This controlled study of children with ALL developed CNS leukemia. #{231}raniospinal was designed to determine in a prospective irradiation was associated with more manner the relative efficacy and toxicity of leukopenia and interruptions of chemo-two forms of “prophylactic ” CNS therapy therapy. “Pulses ” were not associated with for preventing CNS relapse and of periodic improvement of remission duration. Our vincristine-prednisone “pulses ” during current choice of CNS therapy is cranial multiple agent chemotherapy. Following irradiation plus intrathecal methotrexate cranial irradiation (2400 rads) plus intra- because it takes less time and may avoid thecal methotrexate, 3 of 45 patients de- demonstrated short-term side effects and veloped CNS leukemia. Following cranio- possible long-term effects of spinal ir-spinal irradiation (2400 rads), 2 of 49 radiation. S INCE 1962 childhood acute lymphocytic leukemia (ALL) has been treated at this institution with combinations of “prophylactic ” central nervous system (CNS) irradiation and simultaneous multiple-agent chemotherapy. ‘ A 17 % 7-yr leukemia-free remission rate was obtained in the earlier studies, bu