Controversies in the management of central nervous system leukemia

Julio Barredo, A. Kim Ritchey

Research output: Contribution to journalComment/debatepeer-review

14 Scopus citations


The central nervous system (CNS) has long been recognized as a site, indeed a sanctuary, for leukemic cells. Although few (<5) patients with acute lymphoblastic leukemia (ALL) actually present with overt CNS leukemia, without prophylactic CNS-directed treatment, over 50 will develop CNS disease. However, with modern CNS prophylaxis, the incidence of CNS relapse has been reduced to 6 or less. Although great progress has been made, we continue to struggle with management of CNS leukemia. This commentary will address issues of CNS leukemia treatment at diagnosis and at relapse. Topics that will be addressed include (1) CNS 2 status at diagnosisdefinition and treatment; (2) CNS leukemia at diagnosis treatment with radiation therapy; (3) isolated relapse of leukemia in the CNS treatment of early and late relapse; and (4) opportunities for future research in CNS relapse of ALL.

Original languageEnglish (US)
Pages (from-to)329-332
Number of pages4
JournalPediatric Hematology and Oncology
Issue number5
StatePublished - Jul 30 2010


  • acute lymphoblastic leukemia
  • central nervous system relapse

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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