This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

CNS involvement in ALL

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

CNS involvement at the time of diagnosis is observed in <5% of children and in <10% of adults with ALL (1).

CNS prophylaxis has been identified as the single best approach in treating patients with CNS leukaemia.

Without CNS prophylaxis

  • 50-75% of patients eventually will develop CNS disease
  • CNS recurrence occurs in approximately 30 - 50% of patients who have achieved complete remission (1)

CNS recurrence is associated with a poor prognosis (1).

CNS relapse has been observed in 30-40% of initial relapses in some studies (1).

The following factors are associated with an increased risk of CNS relapse:

  • a T-cell immunophenotype
  • hyperleucocytosis
  • high-risk genetic abnormalities
  • presence of leukaemic cells in cerebrospinal fluid

Due to the associated acute and late complications (e.g. - second cancers, late neurocognitive deficits, and endocrinopathy), cranial irradiation is limited to patients who are at high risk of a CNS relapse (1,2).

Intrathecal and systemic chemotherapy have replaced cranial irradiation (1).

  • triple intrathecal therapy with methotrexate, cytarabine, and hydrocortisone is effective in preventing CNS relapse (2)


Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.