Journal ArticleDOI
The increasing incidence of central nervous system leukemia in children. (Children's cancer study group a)
TLDR
It is concluded that the increasing survival of children with leukemia is the chief cause for the increased incidence of CNS leukemia, as noted by many investigators.Abstract:
The incidence of symptomatic CNS leukemia was studied in 209 children, all of whom were entered in a cooperative study during 1963-1964, and received the same chemotherapeutic agents. The overall incidence was 51%, and the median time for occurrence of the first episode was 9 months. The incidence was 56% in patients with acute lymphocytic leukemia (A. L. L.) and 25% in those with other forms of leukemia. CNS symptoms developed at a steady monthly rate of 3.8% for the first 24 months and then decreased to 2%. The rate for the first year was the same for all forms of leukemia; it was 4% in A. L. L. and 3.7% in the other forms combined. The overall median survival was 18 months—it was 21 months for patients with A. L. L. and 9 months for the other cell types. Life-table analysis showed a median survival of 8 months for patients who had developed CNS leukemia and 24 months for those free of the complication. Age, sex, hematologic status, and chemotherapy regimen did not influence the incidence. We conclude that the increasing survival of children with leukemia is the chief cause for the increased incidence of CNS leukemia noted by many investigators.read more
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Multidrug-resistance gene (P-glycoprotein) is expressed by endothelial cells at blood-brain barrier sites.
Carlos Cordon-Cardo,James P. O'Brien,Dolors Casals,Lana Rittman-Grauer,June L. Biedler,Myron R. Melamed,Joseph R. Bertino +6 more
TL;DR: P-glycoprotein expression in capillary endothelium of brain and testes and not other tissues (i.e., kidney and placenta) may in part explain this phenomenon and could have important implications in cancer chemotherapy.
Journal ArticleDOI
Expression of the multidrug resistance gene product (P-glycoprotein) in human normal and tumor tissues.
TL;DR: Pgp expression in capillaries of the brain and testis may explain the failure of drugs such as vincristine and actinomycin-D to penetrate into tissues, allowing them to remain as pharmacological sanctuaries for malignant cells.
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Diagnosis and treatment of leptomeningeal metastases from solid tumors: Experience with 90 patients
TL;DR: It is concluded that vigorous treatment of leptomeningeal metastases with intrathecal chemotherapeutic agents improves symptomatology in some patients, and at times prolongs survival.
Journal ArticleDOI
Neurotoxicity of Commonly Used Antineoplastic Agents
TL;DR: The broad concept of "carcinomatous neuromyopathy" is frequently invoked to explain obscure neurologic symptoms in patients with cancer, but it is also important to realize that neurologic dysfunction may be iatrogenic — i.e., caused by the treatment of cancer.
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Disseminated necrotizing leukoencephalopathy: A complication of treated central nervous system leukemia and lymphoma
TL;DR: This report describes a form of disseminated necrotizing leukoencephalopathy that has been observed in four children with acute lymphoblastic leukemia, and one child with Burkitt's lymphoma terminating in a leukemic phase, which developed either at or shortly after the completion of combined triple intrathecal therapy.
References
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Journal ArticleDOI
Maximum utilization of the life table method in analyzing survival
Sidney J. Cutler,Fred Ederer +1 more
TL;DR: Acceptance of survival as a criterion for measuring the effectiveness of cancer therapy is attested to by the very large number of papers published every year reporting on the survival experience of cancer patients.
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Central nervous system involvement by leukemia in children. i. relationship to systemic leukemia and description of clinical and laboratory manifestations.
TL;DR: The development of CNS involvement does not appear to shorten the survival time of patients with leukemia when treatment for CNS involvement is given, and the onset of CNS symptoms was less frequent when the systemic disease was under treatment with steroids.
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Intracranial complications of leukemia in children.
TL;DR: The available evidence suggests that such agents as 6-mercaptopurine and Methotrexate® which are known to cross the blood-brain barrier in greatly reduced amounts fail to control the intracranial progression of leukemia even though the disease may be under fair control elsewhere in the body.
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