Central Nervous System Involvement by Leukemia in Children. I. Relationship to Systemic Leukemia and Description of Clinical and Laboratory Manifestations.

By CAROL B. HYMAN, JAMES M. BOyLE, ChARLES A. BRUBAKER, KENNETH WILLiAMS AND DENMAN HAMMOND p RESENT UNDERSTANDING of the pathologic and clinical implications of central nervous system (CNS) infiltration by leukemia is based on reports involving relatively small numbers of patients.’#{176} Some previous reports have dealt with neurologic complications of all types in association with leukemia including hemorrhage and infection as well as involvement of the CNS by leukemia.4’7’8 This report deals exclusively with CNS involvement by the leukemic process. No distinction is made between involvement of the brain, meninges or nerve roots. The data is based on observations of 109 episodes due to CNS infiltration which occurred in 59 children with leukemia. A clinical description of CNS leukemia including incidence in relation to systemic leukemia, effect on the prognosis for duration of life and signs, symptoms and laboratory findings is presented. A separate communication reports the experience in management of CNS leukemia with intrathecal methotrexate.9