Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Central nervous system leukemia.

W A Bleyer1

  • 1University of Washington School of Medicine, Seattle.

Pediatric Clinics of North America
|August 1, 1988
PubMed
Summary
This summary is machine-generated.

Reducing neurotoxicity in cancer therapy is key. Fewer treatment combinations, especially avoiding central nervous system radiation therapy (CNS RT), are safer. High-dose methotrexate (MTX) shows promise as a single, less toxic modality.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The management of cancer in the older adolescent.

European journal of cancer (Oxford, England : 1990)·2003
Same author

Importance of dose intensity in neuro-oncology clinical trials: summary report of the Sixth Annual Meeting of the Blood-Brain Barrier Disruption Consortium.

Neuro-oncology·2001
Same author

Children's Cancer Group trials in childhood acute lymphoblastic leukemia: 1983-1995.

Leukemia·2001
Same author

Oral cancer chemotherapy in paediatric patients: obstacles and potential for development and utilisation.

Drugs·2000
Same author

Epidemiologic impact of children with brain tumors.

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery·1999
Same author

Intrathecal depot cytarabine therapy: a welcome addition to a limited armamentarium.

Clinical cancer research : an official journal of the American Association for Cancer Research·1999
Same journal

Barriers, Breakthroughs, and the Future of Pediatric Dermatologic Care.

Pediatric clinics of North America·2026
Same journal

Advancing Pediatric Dermatology: Innovations in Care and Access.

Pediatric clinics of North America·2026
Same journal

No Child Left Behind: Advancing Access in Pediatric Dermatology, a 4-Year, Single-Center Experience.

Pediatric clinics of North America·2026
Same journal

Telemedicine and Access to Pediatric Dermatology Care.

Pediatric clinics of North America·2026
Same journal

Inequitable Reimbursement for Pediatric Providers: A Review of Structural Factors that Disincentivize the Care of Children.

Pediatric clinics of North America·2026
Same journal

Medical Photography's Power to Change Medical Care.

Pediatric clinics of North America·2026
See all related articles

Area of Science:

  • Pediatric Oncology
  • Neuro-oncology
  • Clinical Pharmacology

Background:

  • Neurotoxicity is a significant concern in cancer treatment, particularly in pediatric patients.
  • The risk and severity of neurotoxicity correlate with the number of therapeutic modalities used.
  • Combinations involving central nervous system radiation therapy (CNS RT) are often the most neurotoxic.

Purpose of the Study:

  • To evaluate the neurotoxicity associated with different therapeutic modalities for central nervous system (CNS) prophylaxis in pediatric cancers.
  • To identify safer treatment combinations and single agents to minimize neurological sequelae.
  • To assess the efficacy and safety of various CNS treatment strategies in preventing overt CNS leukemia.

Main Methods:

  • Review of clinical data from trials evaluating different combinations of chemotherapy and radiation therapy for CNS prophylaxis.

Related Experiment Videos

  • Analysis of neurotoxicity outcomes (acute, subacute, delayed) based on the number and type of therapeutic agents used.
  • Comparison of outcomes, including intellectual and academic performance, between different treatment arms.

    • Main Results:

    • The risk and severity of neurotoxicity are directly proportional to the number of therapeutic modalities employed.
    • Combinations including CNS RT are generally the most neurotoxic.
    • High-dose methotrexate (MTX) appears to be the safest single modality, and the combination of intrathecal (IT) MTX with high-dose intravenous MTX is the least neurotoxic combination of two modalities.
    • Sequential administration of IT MTX or high-dose intravenous MTX followed by CNS RT is less neurotoxic than concurrent administration.
    • Avoiding ionizing radiation and IT chemotherapy may be possible for some patients, but chemoradiotherapy with cranial RT and IT MTX remains standard for preventing overt CNS leukemia.

    Conclusions:

    • Treatment strategies involving fewer therapeutic modalities, particularly those avoiding CNS RT, are associated with reduced neurotoxicity.
    • High-dose MTX represents a relatively safe single agent for CNS prophylaxis.
    • While striving to minimize neurotoxicity, established chemoradiotherapy regimens are crucial for preventing symptomatic CNS leukemia and improving cure rates in high-risk pediatric patients.