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Studies on the assessment of neurotoxicity in children with acute lymphoblastic leukemia
Author(s) -
Muchi Hiromu,
Satoh Takami,
Yamamoto Kayoko,
Karube Toshiaki,
Miyao Masutomo
Publication year - 1987
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19870301)59:5<891::aid-cncr2820590506>3.0.co;2-m
Subject(s) - medicine , methotrexate , neurotoxicity , prophylactic cranial irradiation , cerebrospinal fluid , leukemia , central nervous system , acute lymphocytic leukemia , incidence (geometry) , lymphoblastic leukemia , toxicity , physics , myocardial infarction , conventional pci , optics
Central nervous system (CNS) prophylaxis caused a remarkable reduction in the incidence of CNS disease, however there has evolved a growing concern regarding the immediate or late toxicities to the developing CNS. Twenty‐eight children with acute lymphoblastic leukemia who survived for more than 2 years were examined for the assessment of neurotoxicity induced by CNS prophylaxis and its treatment. The patients were stratified into three groups: Stratum I, prophylaxis with methotrexate; Stratum II, prophylaxis with cranial irradiation with methotrexate; and Stratum III, with CNS leukemia. Once CNS disease developed the sequelae were frequent and severe, due to the elevated methotrexate levels in the cerebrospinal fluid. CNS prophylaxis with intermediate‐dose methotrexate was less toxic to the developing CNS than prophylactic cranial irradiation, especially in children under 5 years of age. Electroencephalograms and evoked potentials are likely to find increasing application in defining the CNS sequelae of acute lymphoblastic leukemia in children and its treatment. Although the sample size was small, the findings delineate specific areas of neurotoxicity. Cancer 59:891‐895, 1987.