Abstract
TO THEEDITOR:WithinterestwehavereadthestudybyZelleret al 1 in Journal of Clinical Oncology. In their cross-sectional study, the authors compared regional brain volumes in 130 adult long-term survivors of childhood acute lymphoblastic leukemia (ALL) with thoseinhealthycontrols.Inthisstudy,ALLsurvivorshadbeentreated withchemotherapyconsistingofvincristine,methotrexate,andantracyclines. To prevent CNS leukemia, most ALL survivors had received intrathecal injections of methotrexate, whereas only 13.8% of the survivors had received cranial irradiation. Structural magnetic resonanceimagingshowedsmallervolumesofmultiplebrainstructuresin long-term survivors of childhood ALL compared with matched healthy controls. Although the study contained the largest number of participantstodate,Zelleretalcouldnotidentifyetiologicfactorsthat
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