The intraventricular reservoir in the treatment of neurological disease secondary to hematological malignancy: an eight year experience.

Between 1974 and 1982, 17 patients with central nervous system disease secondary to hematological malignancy had an intraventricular reservoir inserted to monitor their disease and to instill cytotoxic chemotherapy. Two other patients with acute lymphoblastic leukemia and difficult access to the cerebrospinal fluid had a reservoir inserted to facilitate intrathecal chemotherapy. All 17 patients with established disease showed clinical improvement. Thirteen patients had complete elimination of malignant cells from the cerebrospinal fluid with cytotoxic chemotherapy, and the other four had a reduction in the concentration of malignant cells. Infection and neurotoxicity were found in a significant number of cases, and therefore the good clinical response associated with the procedure must be weighed carefully against the associated toxicity.