Sequelae of Central Nervous System Prophylaxis

Most patients with acute lymphoblastic leukaemia receive central nervous system (CNS) prophylaxis without severe side effects. A few children suffer adverse effects, varying from a meningeal reaction to irreversible nerve damage producing paraplegia (Gagliano and Costanzi, 1976), optic atrophy (Fishman et al., 1976; Margileth et al., 1977) and disturbance of cerebellar or higher mental functions (Kay et al., 1972; Price and Jamieson, 1975). We do not know whether the higher incidence of cerebral tumours reported by Madan et al. (1974) with radiotherapy to the scalp will also be found after CNS prophylaxis.