Central Nervous System (CNS) Involvement in Acute Nonlymphocytic Leukemia (ANLL)

The incidence of central nervous system (CNS) involvement and effects of therapy were reviewed in 42 consecutive pediatric patients with acute nonlymphocytic leukemia (ANLL). The morphology of ileukemic cells was considered M1 in 13, M2 in 7, M3 in 5, M4 in 8, and M5 in 9. Two patients with M5 morphology presented with CNS disease at diagnosis. Systemic Ara-C treatment was included as a mainstay of remission induction and maintenance program for all patients. With the exception of the M5 group, none of the patients received direct CNS prophylactic therapy. There was a 0% incidence of CNS relapse: in this group of patients. Median duration of remission for all patients (excluding the M5 group) was 33 months. This experience may indicate that systemic treatment with Ara-C may provide some degree of CNS prophylaxis in ANLIL.