Cranial nerve palsy in childhood acute lymphoblastic leukemia and non‐Hodgkin's lymphoma

Forty‐five children with acute lymphoblastic leukemia or non‐Hodgkin's lymphoma had cranial nerve palsy (CNP) as a complication of their disease. Twenty‐two of these children had CNP initially and 23, at relapse, with or without previous hematologic relapse. Only one of the 23 patients with CNP at relapse was a longterm survivor. In contrast, 11 of the 22 children who had CNP initially survived in remission for 3+ months to 13+ years. Two factors are associated with an improved outcome for patients with CNP at diagnosis: treatment after 1979 (P < 0.004) and male gender (P < 0.01). Patients who received radiation therapy fared better than those for whom radiation was not given (disease‐free survival at 2 years 53% versus 29%). The authors conclude that CNP signifies an aggressive or advanced disease requiring intensive systemic chemotherapy and that the role of irradiation should be examined for this group of patients.