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Correlation between cranial computed tomographic scans at diagnosis in children with acute lymphoblastic leukaemia and central nervous system relapse



Correlation between cranial computed tomographic scans at diagnosis in children with acute lymphoblastic leukaemia and central nervous system relapse



Lancet 2(8622): 1212-1213



145 children with acute lymphoblastic leukaemia (ALL) were evaluated over a period of 3 years in a multicentre study in which serial cranial computed tomographic (CT) scans of the brain were done. All patients were symptom-free. CT scans were graded as normal, borderline (slight or moderate cerebral atrophy), or pathological (severe cerebral atrophy), 62% (90/145) of children had CT scan abnormalities at diagnosis. After a median follow-up of 24 months (range 6-36) 12 of 108 evaluable patients had central nervous system (CNS) relapses (6 isolated relapses and 6 combined with relapse at another site). All patients with CNS relapse had an anormal CT scan at diagnosis (8 pathological and 4 borderline). No relapses were observed among the 42 patients with a normal cranial CT scan at diagnosis. A significantly higher proportion of severe cerebral atrophy, both following CNS prophylaxis after the discontinuation of treatment, was found among patients with a borderline CT scan at diagnosis than among patients with a normal CT scan at diagnosis. Thus an abnormal cranial CT scan at diagnosis in children with ALL seems to have prognostic significance.

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Accession: 007163164

Download citation: RISBibTeXText

PMID: 2903952

DOI: 10.1016/s0140-6736(88)90809-4


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