Use of cytosar in pediatric acute myelocytic leukemia and leukemic meningitis

For children with acute myelocytic leukemia, 5‐day courses of Cytosar in combination with cyclophosphamide (with or without vincristine sulfate and prednisone) has shown excellent, age related results in relapse patients. The regimen known as Mini‐COAP has been incorporated into front‐line studies. Cytosar given intrathecally in combination with methotrexate has produced superior results in treating meningeal disease in the African presentation of Bur‐kitt disease. This “synchronizing” technique has been incorporated into a high Cytoxan‐high methotrexate regimen with coordinated intrathecal therapy with good results. Triple (Cytosar, methotrexate, and hydrocortisone) intrathecal prophylaxis is now demonstrated to have equivalent effectiveness to conventional CNS prophylaxis employing radiotherapy 2400 R and 5 doses of intrathecal methotrexate.