title: Treatment of overt CNS leukemia.
abstract: At this time, methotrexate and CNS radiotherapy used together offer the best chance for prolonged remissions in children who develop overt CNS leukemia. Toxicity is a major problem. Unless a lower dose of radiation is used, the contribution of radiotherapy to neurotoxicity cannot be reduced. However, the toxicity of intrathecal methotrexate can be reduced by using Elliot's B as a diluent, combining methotrexate with hydrocortisone, and using a standard dose after the age of 3 years rather than a dose based on body surface area. Fortunately, the incidence of CNS leukemia has decreased over the years due to prophylactic CNS therapy. However, when a CNS relapse does occur, it carries a grave prognosis and is therefore still a significant problem necessitating continued research.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000630:Aminopterin / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001215:Asparaginase / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000187:drug effects; D002330:Carmustine / Q000627:therapeutic use; D002648:Child; D003561:Cytarabine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007278:Injections, Spinal; D007938:Leukemia / Q000188:drug therapy / Q000517:prevention & control* / Q000532:radiotherapy; D008577:Meningeal Neoplasms / Q000188:drug therapy / Q000517:prevention & control* / Q000532:radiotherapy; D008727:Methotrexate / Q000627:therapeutic use; D011739:Pyrimethamine / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D003561:Cytarabine; D001215:Asparaginase; D000630:Aminopterin; D002330:Carmustine; D008727:Methotrexate; D011739:Pyrimethamine