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Central Nervous System Involvement in Adult Acute Lymphocytic Leukemia

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Acute Leukemias

Part of the book series: Hematologic Malignancies ((HEMATOLOGIC))

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Abstract

Central nervous system (CNS) involvement is identified at the time of diagnosis in less than 5% of children with acute lymphoblastic leukemia (ALL) [1]. However, prior to the institution of adequate CNS prophylaxis, it was a major obstacle to cure in childhood ALL as 50–75% of patients would eventually relapse in the CNS [1, 2]. The routine use of CNS prophylaxis has improved the long-termprognosis of patients, and CNS relapse occurs in less than 10% of patients treated with contemporary protocols [3]. Effective means of CNS prophylaxis include cranial irradiation, intrathecal chemotherapy (IT), and high-dose systemic chemotherapy (HDCT) with agents that can cross the blood-brain barrier [4]. A risk-oriented approach has been developed for childhood CNS prophylaxis, in an attempt to reduce the occurrence of CNS relapse while minimizing the potentially serious adverse effects of radiotherapy and chemotherapy [4].

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Authors and Affiliations

  1. Department of Cancer Medicine, Unit 10, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Ricardo H. Alvarez

  2. Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Jorge E. Cortes

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  1. Ricardo H. Alvarez
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Alvarez, R.H., Cortes, J.E. (2008). Central Nervous System Involvement in Adult Acute Lymphocytic Leukemia. In: Acute Leukemias. Hematologic Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-72304-2_21

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