title: Comparison of three methods of central-nervous-system prophylaxis in childhood acute lymphoblastic leukaemia.
abstract: A retrospective comparison was made of three methods of central-nervous-system prophylaxis in childhood acute lymphoblastic leukaemia; (1) intrathecal methotrexate only; (2) intermediate-dose methotrexate infusion and intrathecal methotrexate and, (3) 2400 rads cranial irradiation and intrathecal methotrexate. The incidence of primary meningeal relapse was statistically significantly lower in both standard-risk patients (age grear than 24 months and less than or equal to 120 months white-cell count less than 20,000) and increased-risk patients (age less than or equal to 24 months or greater than 120 months and/or white-cell count greater than 20,000) whose central-nervous-system prophylaxis included cranial irradiation. The disease-free and overall survival of irradiated increased-risk patients was significantly better than that of unirradiated increased-risk patients. The disease-free survival of standard-risk patients who received intermediate-dose methotrexate was statistically superior to that of the remaining standard-risk patients. There were no significant differences in overall survival between the three groups of standard-risk patients.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006689:Hodgkin Disease / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral; D007278:Injections, Spinal; D007945:Leukemia, Lymphoid / Q000517:prevention & control* / Q000532:radiotherapy; D008577:Meningeal Neoplasms / Q000517:prevention & control* / Q000532:radiotherapy; D008727:Methotrexate / Q000008:administration & dosage*; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012306:Risk
chemical_list: D008727:Methotrexate