CONSEQUENCES OF CNS PROPHYLAXIS IN CHILDREN WITH ALL

急性淋巴细胞白血病（ALL）儿童的生存率 在过去的十年里得到了显著的改善。 主要贡献 成功治疗的特点是引入中枢神经系统 中枢神经系统（CNS）预防（鞘内注射甲氨蝶呤和颅内注射） 照射）。 然而，现在发现许多长期幸存者 表现出认知缺陷 该减值一般归因于 发育中的神经系统在发育过程中受到的损害 治疗 儿童在接受治疗时的年龄显然是一个 关键因素 现有的研究表明， 当治疗时表现出更严重的缺陷。 本研究旨在详细研究中枢神经系统 损害CNS预防性给药的年龄。 具体而言，我们将确定减值的严重程度和性质 与治疗年龄、治疗后时间的作用有关，以及 与危及生命的疾病相关的实验因素在 童年. 计划进行一项回顾性研究， 长期幸存者将接受详细的神经和 神经心理学评估 本研究将提供CNS后遗症的详细评估 预防。 它的研究结果将对评估 治疗的相对风险和益处，以及提供足够的 为越来越多的长期幸存者提供咨询和治疗 他们的认知和行为 困难 此外，这项研究提供了一个独特的机会， 深入了解人类中枢神经系统发育的正常和异常过程， 早年生活。

Survival rates for children with acute lymphoblastic leukemia (ALL) have been improved dramatically in the last decade. A major contributing feature of successful therapy was the introduction of central nervous system (CNS) prophylaxis (intrathecal methotrexate and cranial irradiation). However, many long-term survivors have now been found to exhibit cognitive deficits. This impairment is generally attributed to damage sustained by the developing nervous system in the course of treatment. The child's age at the time of treatment is apparently a critical factor. Existing studies suggest that children who are younger when treated exhibit more severe deficits. The proposed study is a detailed examination of the relationship of CNS impairment to the age at which CNS prophylaxis is administered. Specifically, we shall determine how the severity and nature of impairment are related to treatment age, the role of time elapsed since treatment, and the role of experimental factors related to life-threatening illness in childhood. A retrospective study is planned in which approximately 100 long-term survivors will receive a detailed neurological and neuropsychological evaluation. This study will provide a detailed assessment of the sequelae of CNS prophylaxis. Its findings will be of considerable value in evaluating the relative risks and benefits of treatment as well as in providing adequate counseling and treatment for the increasing number of long-term survivors who are now presenting with significant cognitive and behavioral difficulties. In addition, the study provides a unique opportunity to gain insight into normal and abnormal processes of human CNS development in the early years of life.