Central nervous system directed therapy in acute lymphoblastic leukaemia

CNS-directed treatment is an essential component of therapy for both children and adults with acute lymphoblastic leukaemia. The choice between combinations of i.t. drugs, radiotherapy and high-dose systemic chemotherapy is not a clear one and will depend on the age of the patient, the type of leukaemia and indeed the available treatment facilities. A plea is made for any prospective trials of CNS-directed therapy to incorporate formal assessment of neuropsychological performance, and in the young child, of growth and pubertal progression.