The increasing incidence of central nervous system leukemia in children. Children's cancer study group a

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. Copyright © 1970 American Cancer Society