MAGNETIC-RESONANCE-IMAGING AND NEUROLOGICAL EVALUATION AFTER TREATMENT WITH HIGH-DOSE METHOTREXATE FOR ACUTE LYMPHOCYTIC-LEUKEMIA IN YOUNG-CHILDREN

This study evaluates the occurrence of permanent cerebral white matter changes and neurological abnormalities in children treated at a young age for acute lymphocytic leukaemia. Our pilot treatment protocol did not include central nervous system irradiation, but intrathecal metho trexate and high-dose methotrexate infusions followed by very intensiv e folinic acid rescue. We examined 12 children in complete remission a nd off therapy 18 months to 9.5 years after their last methotrexate in fusion. They were below 5 years of age at diagnosis and therefore expe cted to be at special risk of neurotoxic sequelae. Cerebral magnetic r esonance imaging in the 11 cases thus evaluated did not reveal white m atter abnormalities or other signal changes as signs of permanent trea tment-related sequelae. We did not observe any pathological clinical n eurological findings likely due to methotrexate.