title: [Complications in the central nervous system during chemotherapy for childhood acute lymphoblastic leukemia: JACLS ALL-02 study].
abstract: We evaluated central nervous system (CNS) complications treated under the ALL-02 protocol of the Japan Association of Childhood Leukemia Study (JACLS) from April 2002 to March 2005. According to NCI Toxicity Criteria, 17 events of grade 3 and 4 CNS complications were reported in 15 out of 541 patients. Out of these CNS complications, leukoencephalopathy was seen in 5 patients; seizure in 5; cerebrovascular disease in 3; conscious disturbance in 2; and hypertensive encephalopathy and reversible posterior leukoencephalopathy syndrome in one patient each. The complications were intensively observed during induction therapy and the last of the early phase chemotherapy. The protocol treatment was stopped or modified in most patients after CNS complications. MRI imaging demonstrated no improvement in one patient with leukoencephalopathy who developed an isolated CNS relapse, while other patients were alive and remain in their first complete remission without any neurological sequelae. Further studies will be required to analyze risk factors for CNS complications during chemotherapy not accompanied by irradiation and to establish alternative treatments after the appearance of such CNS complications.
authors: Department of Pediatrics, Kyoto University.
authors: Katsutsugu
authors: K
authors: Umeda
authors: Makoto
authors: M
authors: Yoshida
authors: Nobuhiro
authors: N
authors: Suzuki
authors: Mikiya
authors: M
authors: Endo
authors: Atsushi
authors: A
authors: Sato
authors: Hiroki
authors: H
authors: Hori
authors: Mitsuharu
authors: M
authors: Isogai
authors: Kimikazu
authors: K
authors: Matsumoto
authors: Jun-iIchi
authors: JI
authors: Hara
authors: Daiichiro
authors: D
authors: Hasegawa
authors: Yoshiko
authors: Y
authors: Hashii
authors: Kosuke
authors: K
authors: Chayama
authors: Ryousuke
authors: R
authors: Miyaji
authors: Shin-ichiro
authors: S
authors: Nishimura
authors: Akihiko
authors: A
authors: Tanizawa
authors: Ikuya
authors: I
authors: Uami
authors: Keizo
authors: K
authors: Horibe
authors: Yoshihiro
authors: Y
authors: Wakazono
authors: Keiko
authors: K
authors: Yagi
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002493:Central Nervous System Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012074:Remission Induction; D012307:Risk Factors
chemical_list: D008727:Methotrexate