Intracranial Complications of Leukaemia Treated with Intrathecal Amethopterin

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Abstract
Two children with acute leukemia were treated with 6-mercaptopurine for 10 and 15 months respectively before they developed swellings on the skull which were presumed to be leukemic deposits. The first child also had neurological signs and both had changes in the cerebrospinal fluid (CSF) suggestive of intracranial deposits. After treatment with intrathecal amethopterin, the neurological signs disappeared and the CSF cleared. In one child these signs reappeared eight months later, but although the CSF responded to intrathecal treatment, the child died. The swellings also disappeared in the first patient and diminished temporarily in the second. The reason for this disappearance is discussed. Stress is laid on the importance of frequent examination of the fundi of patients with this disease.

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