832 ABNORMAL CT BRAIN SCANS IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA (ALL)

Abstract

The results of CT brain scans in 2 groups of children with ALL are reviewed. In Group I, 25 asymptomatic children 3-5 yrs from initial diagnosis were studied upon discontinuation of therapy. Mild ventricular dilation (5/25) and cerebral calcifications (1/25) were noted. Of the 6 patients with abnormal CT scans, radiotherapy + intrathecal methotrexate were used in 4/6 patients and intrathecal therapy alone in 2/6 patients. Subsequent neurological complications were uncommon (1/25). In Group II, 14 children who developed neurologic syndromes were studied while still receiving therapy. Leukoencephalopathic syndromes were diagnosed in 10/14 children; central nervous system (CNS) leukemia occurred in 6/10 children. CT scan abnormalities occurred in 9/10 patients. CT scans indicated ventricular dilation alone in 1 patient, and both ventricular and subarachnoid space dilation in 8 patients; in addition, 2 patients had areas of intracerebral calcification in areas of decreased attenuation coefficient. CNS infections were subsequently identified in 2/10 patients (toxoplasmosis and St. Louis encephalitis). Significant CT scan abnormalities are more likely to be seen in patients with antecedent clinical problems or in patients receiving more intensive CNS therapy.