Central nervous system lesions in childhood leukemia

Central nervous system (CNS) lesions were found in 85 of 91 children with acute leukemia. Cerebral atrophy was the most common lesion, occurring in 65 percent. Atrophy was most severe in children treated with intrathecal methotrexate alone or in combination with radiation therapy, in children youngest at time of onset of leukemia, and in children in whom duration of leukemia was shortest. Longer duration was the determining factor among children who were older at onset. Lesions previously reported by other investigators, such as leptomeningeal infiltration of leukemic cells, infection, hemorrhage, degenerative grey and white matter disease and leukoencephalopathy were also seen. Central pontine myelinolysis occurred in four children.