Cranial nerve palsy in childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma.
Forty-five children with acute lymphoblastic leukemia or non-Hodgkin's lymphoma had cranial nerve palsy (CNP) as a complication of their disease. Twenty-two of these children had CNP initially and 23, at relapse, with or without previous hematologic relapse. Only one of the 23 patients with CNP at relapse was a long-term survivor. In contrast, 11 of the 22 children who had CNP initially survived in remission for 3+ months to 13+ years. Two factors are associated with an improved outcome for patients with CNP at diagnosis: treatment after 1979 (P less than 0.004) and male gender (P less than 0.01). Patients who received radiation therapy fared better than those for whom radiation was not given (disease-free survival at 2 years 53% versus 29%). The authors conclude that CNP signifies an aggressive or advanced disease requiring intensive systemic chemotherapy and that the role of irradiation should be examined for this group of patients.
Ingram
L C
LC
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Fairclough
D L
DL
Furman
W L
WL
Sandlund
J T
JT
Kun
L E
LE
Rivera
G K
GK
Pui
C H
CH
D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003389:Cranial Nerve Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000532:radiotherapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000532:radiotherapy; D011379:Prognosis; D011879:Radiotherapy Dosage; D012737:Sex Factors; D016019:Survival Analysis
D008727:Methotrexate