Acute lymphoblastic leukemia in adults: results of intraventricular maintenance chemotherapy for central nervous system prophylaxis and treatment.
The results of intraventricular (i.vt.) chemotherapy in 36 cases of adult acute lymphoblastic leukemia (ALL) were analyzed to define a useful and reliable form of central nervous system (CNS) prophylaxis. Patients received methotrexate (MTX) via an Ommaya reservoir six times every 4 weeks. This was repeated when bone marrow relapse occurred. Intraventricular maintenance CNS prophylaxis during half a year appeared adequate, since primary CNS relapses were seen in only two patients (5.6%). These patients had failed to follow the prophylaxis schedule. The procedure was implemented and repeated relatively easily and did not lead to neurotoxic problems. The i.vt. route was also satisfactory for the treatment of initial and recurrent episodes of meningeal leukemia (ML). The therapy reduced morbidity caused by ML to a minimum.
Haaxma-Reiche
H
H
Department of Neurology, University of Groningen, The Netherlands.
Daenen
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007276:Injections, Intraventricular; D007945:Leukemia, Lymphoid / Q000188:drug therapy*; D008297:Male; D008577:Meningeal Neoplasms / Q000517:prevention & control*; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D012074:Remission Induction
D008727:Methotrexate