FUNCTIONAL NEUROLOGICAL OUTCOME IN LEUKEMIC CHILDREN RECEIVING REPEATED CRANIAL IRRADIATION

Long-term outcome defined by educational or employment history has bee n recorded in a group of children with acute lymphoblastic leukaemia ( ALL) who received cranial radiotherapy at some stage prior to TBI cond itioned bone marrow transplant (BMT). Median follow-up in 24 survivors of 69 consecutive patients was 4 years and 2 months. Individual risk factors for poor functional outcome were considered, including calcula tions of biological effective radiation doses. There was no incidence of CNS treatment-related mortality. All survivors are in normal school or employment, although three who had CNS relapse are receiving remed ial teaching. No individual risk factors could be identified but the w orst outcome was seen in children who were of young age at the time of initial treatment, who suffered CNS relapse and who had received the highest total dose of cranial irradiation.