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NEUROLOGY 1984;34:229
© 1984 American Academy of Neurology

CT abnormalities and altered methotrexate clearance in children with CNS leukemia

Patricia K. Duffner, MD, Michael E. Cohen, MD, Martin L. Brecher, MD, Paul Berger, MD, K. L. Parthasarathy, MD, Suraj Bakshi, MD, Lawrence J. Ettinger, MD and Arnold Freeman, MD

From the Departments of Neurology (Drs. Duffner and Cohen), Pediatrics (Drs. Brecher and Freeman), and Radiology (Dr. Berger), SUNYAB, Buffalo, NY, the Department of Nuclear Medicine (Drs. Parthasarathy and Bakshi), Roswell Park Memorial Institute, Buffalo, New York, and Children's Hospital of Los Angeles (Dr. Ettinger), Los Angeles, CA.

Seventeen children with CNS leukemia treated with chemotherapy and 5 children treated with both cranial radiation (CRT) and chemotherapy were evaluated. Eighty-eight percent of patients treated with chemotherapy alone had CT abnormalities, and all treated with CRT and chemotherapy had abnormal CT. The severity of CT abnormality paralleled intraventricular methotrexate levels and clinical signs of leukoencephalopathy. Children who receive chemotherapy for CNS leukemia, even without cranial irradiation, are more likely to have leukoencephalopathy than children without CNS leukemia. Moreover, patients with CNS leukemia may have abnormalities of CSF clearance of intraventricularly administered drugs.

Address correspondence and reprint requests to Dr. Duffner, Division of Neurology, Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, NY 14222.

Accepted for publication May 23, 1983.






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