What is included in CNS prophylaxis for acute lymphoblastic leukemia (ALL)?

Updated: Oct 23, 2019
  • Author: Karen Seiter, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Answer

See the list below:

  • Patients with ALL have an increased chance of CNS involvement; therefore, intrathecal (IT) methotrexate is given as CNS prophylaxis

  • CNS prophylaxis consists of methotrexate 12 mg IT on day 2 and cytarabine 100 mg IT on day 8 of each cycle, or similar regimens

  • Patients with a high risk for CNS disease (mature B-cell, high proliferative index, and/or lactate dehydrogenase [LDH] level > 600 U/L [normal range, 25–225 U/L]) receive 16 IT methotrexate treatments

  • Patients with low LDH level and unknown proliferative index receive eight treatments of intrathecal methotrexate


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