Abnormal Ct Scans of the Brain in Asymptomatic Children With Acute Lymphocytic Leukemia After Prophylactic Treatment of the Central Nervous System With Radiation and Intrathecal Chemotherapy

A longitudinal electroencephalographic study in acute leukaemia

“…The EEG was pathologic in approximately 30% of cases of acute leukaemia, both lymphoid and non lymphoid, and borderline in a further 30% of ALL patients and 10% of ANLL patients. Of the 7 patients with normal EEG studied after induction therapy, 4 showed EEG abnormalities which can be attributed to no other cause than the toxicity of the meningeal treatment, above all to 60 Co therapy [%1- [10][11][12][13][14][15]. However, this fact alone does not enable us to find the cause of such functional modifications [7].…”

MRI morphometric and neuropsychological correlates of long‐term memory in survivors of childhood leukemia

“…Ten control children [ages: 6–14; grades: 1–8; 4 males and 6 females; handedness: 1 left; socio‐economic status (SES): 2–9] were group matched to ten ALL children on age [7–14 years], gender [4 males], handedness [1 left], school grade [first‐eight], and SES 1–9. SES was determined using the Hollingshead occupational codes 33, with a score of 1 indicating levels of major professions through a score of 9 indicating unskilled, unemployed, or student positions.…”

“…Since the early 1980s, alternative protocols have been developed involving a combination of chemo‐agents including neurotoxic methotrexate 4. Early computed tomography (CT) and magnetic resonance imaging (MRI) studies with populations of children who received both chemotherapy and irradiation reported ventricular dilation, cortical calcification, and atrophy 5–7 that were more severe compared to children who received chemotherapy only 1. Neuroimaging findings varied, however, from no significant brain abnormalities 8, to transient white matter changes in a small percentage of ALL survivors 9, and to significant widening of the sulci and ventricle in children receiving exclusively chemotherapy 10.…”

Effects of chemotherapy on neurocognitive function in children with acute lymphoblastic leukemia: A critical review of the literature

“…Later 24 Gy cranial irradiation was combined with intrathecally administered methotrexate (MTX). Toxic side effects of CNS irradiation soon became clear: neurological complications 5–7, growth inhibition 8, 9, and second malignancies 10, 11 were reported. As it became evident that in combination with intrathecal MTX, radiation doses could safely be reduced from 24 to 18 Gy 12, treatment protocols were widely adapted accordingly.…”