The relation between age at irradiation, sex, and age at puberty onset was determined in 36 children treated with high-dose irradiation for tumors anatomically distant from the hypothalamic-pituitary region at the New York University Medical Center, St Luke’s/Roosevelt Hospital, and Memorial Sloan Kettering Cancer Center, New York. Twenty six also received chemotherapy. Age at onset of puberty and pubarche was significantly earlier in girls but not in boys. The mean age at onset of puberty in both boys and girls was linearly correlated with age at diagnosis and irradiation, and was inversely related to body weight. 
COMMENT. High dose cranial irradiation may cause precocious puberty in girls, particularly in those who are overweight.
High-dose methotrexate for acute lymphocytic leukemia in young children did not cause neurological abnormalities or MRI changes in a study of 12 children treated at the University Hospital of Tronheim, Norway . Some previous studies have demonstrated reversible acute and subacute neurotoxicity following methotrexate (MTX) therapy for ALL. The possible role of folinic acid rescue in avoiding MTX toxicity needs further study.