Abstract
A total of 40 episodes of CNS leukemia in children were treated with intrathecal Methotrexate alone, or combination regimens with Methotrexate 15 mg/M2, Hydrocortisone 15 mg/M2, and/or Cytosine arabinoside 30 mg/M2.
Complete remission was obtained in 72.5% of 40 episodes of CNS diseases. Median lengths of CNS remission were: “no therapy” maintenance 2.2 months; two and three drug maintenance regimens 11.4 plus months and 17.2 plus months, respectively. Differences were of ststistically significance between “no therapy” maintenance and multiple drug maintenance regimens (P<0.01), and between two and three drug regimens (p=0.05).
Toxicity of the intrathecal chemotherapy for CNS leukemia induction was not prohibitive. However, during the intrathecal maintenance period, headache, fever, and/or vomiting occurred in 15.7% of the children, one or two hours after receiving intrathecal medication. One patient developed leukoencephalopathy due to intrathecal and intravenous Methotrexate, which was morphologically found diffuse reactive astrocytosis and multiple, noninflammatory necrotic foci in telencephalic white matter.
