Low incidence of CNS relapse with cranial radiotherapy and intrathecal methotrexate in acute lymphoblastic leukemia.
OBJECTIVE
To assess the incidence of isolated central nervous system (CNS) relapses in patients of acute lymphoblastic leukemia (ALL) treated with a protocol containing cranial irradiation and intrathecal methotrexate as CNS directed therapy.


METHODS
Prospective non randomized study.


METHODS
Department of Medical Oncology, Tata Memorial Hospital.


METHODS
623 children of ALL on MCP 841.


METHODS
CNS relapse was diagnosed, if upon examination of the CSF, more than 50 cells/microliter were observed, or a count of 5 cells which were unequivocally lymphoblasts.


RESULTS
The incidence of isolated CNS relapse was 1.75% with the use of this treatment. Age, sex, white blood cell count, platelet count, lactic dehydrogenase and immunophenotyping were not significantly related to isolated CNS relapse.


CONCLUSIONS
A low incidence of isolated CNS relapse demonstrates the adequacy of the presymptomatic CNS therapy.
Raje
N S
NS
Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay.
Vaidya
S J
SJ
Kapoor
G
G
Pai
S K
SK
Nair
C N
CN
Kurkure
P A
PA
Magrath
I T
IT
Advani
S H
SH
D000293:Adolescent; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002490:Central Nervous System / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D017254:Leukemic Infiltration / Q000517:prevention & control*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000134:cerebrospinal fluid / Q000473:pathology / Q000628:therapy*
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate