MINOR CHANGES ON CRANIAL MRI DURING TREATMENT IN CHILDREN WITH ACUTE LYMPHOBLASTIC-LEUKEMIA

Cranial MRI was used to study treatment-related changes in children un dergoing therapy for acute lymphoblastic leukaemia (ALL) or lymphoma. Nineteen children (18 with ALL, 1 with lymphoma) underwent MRI at the beginning of treatment and at intervals during it, to a total of 105 i maging studies and a minimum of 3 per case. Nine patients had finished all therapy, all received consolidation treatment, No patient had cen tral ner vous system (CNS) leukaemia at diagnosis or developed a CNS r elapse. Mild treatment-related white matter changes were observed in o nly 2 patients after consolidation therapy with three 5 g/m(2) pulses of intravenous methotrexate. Transient enlargement of the ventricles a nd cortical sulci was observed in 13 patients, always temporally relat ed to steroid treatment. These preliminary data suggest that treatment -related white matter changes are rare and no routine MRI follow-up is needed during treatment in asymptomatic children after a baseline ass essment.