Table 2

Management of CNS leukemia present at diagnosis

1. Intrathecal or intraventricular (Ommaya reservoir) methotrexate 12.5 mg three times weekly until clearance of the cerebrospinal fluid. 
2. Lucovorin 10 mg/m2 intravenously or orally every 6 hours for 4 doses, starting 24 hours after the administration of methotrexate. 
3. Cranial irradiation 2400 cGy and 1200 cGy to the spinal cord administered concurrently with phase 2 of induction. 
4. Systemic chemotherapy is not to be delayed while intrathecal or radiation therapy is given. 
1. Intrathecal or intraventricular (Ommaya reservoir) methotrexate 12.5 mg three times weekly until clearance of the cerebrospinal fluid. 
2. Lucovorin 10 mg/m2 intravenously or orally every 6 hours for 4 doses, starting 24 hours after the administration of methotrexate. 
3. Cranial irradiation 2400 cGy and 1200 cGy to the spinal cord administered concurrently with phase 2 of induction. 
4. Systemic chemotherapy is not to be delayed while intrathecal or radiation therapy is given. 

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