TY - JOUR
T1 - Toxicity and efficacy of intrathecal liposomal cytarabine in children with leukemia/lymphoma relapsing in the central nervous system: A retrospective multicenter study
AU - Parasole, R.
AU - Petruzziello, F.
AU - Messina, C.
AU - Barisone, E.
AU - Pession, A.
AU - Locatelli, Franco
AU - Micalizzi, C.
AU - Cesaro, S.
AU - Testi, A. M.
AU - De, Matteo A.
AU - Varotto, S.
AU - Berger, M.
AU - Morello, W.
AU - Menna, G.
AU - Poggi, V.
PY - 2015
Y1 - 2015
N2 - The toxicity and efficacy of intrathecal liposomal cytarabine (LC) were evaluated in children with central nervous system (CNS) relapsed/refractory acute leukemia/lymphoma. Thirty patients (male:female ratio 21:9; median age 9.4 years) with CNS relapsed/resistant disease were treated with intrathecal LC at dosages adjusted for age. Twenty-seven (90%) patients simultaneously received systemic chemotherapy, including concurrent high-dose cytarabine or methotrexate in 21 (70%) cases. Of 28 patients evaluable for response, 25 patients (89%) achieved CNS complete remission and three (11%) partial remission. The median number of intrathecal LC administrations per patient was 4. The cerebrospinal fluid was cleared after a median of 3 intrathecal LC administrations. Neurological toxicity ≥ grade 3 occurred in four (13%) patients. No permanent sequelae were observed. The median overall survival was 20.9 months and the 5-year probability of survival was 46%. These encouraging data suggest that intrathecal LC is well tolerated and effective in children with relapsed/refractory CNS leukemia/lymphoma.
AB - The toxicity and efficacy of intrathecal liposomal cytarabine (LC) were evaluated in children with central nervous system (CNS) relapsed/refractory acute leukemia/lymphoma. Thirty patients (male:female ratio 21:9; median age 9.4 years) with CNS relapsed/resistant disease were treated with intrathecal LC at dosages adjusted for age. Twenty-seven (90%) patients simultaneously received systemic chemotherapy, including concurrent high-dose cytarabine or methotrexate in 21 (70%) cases. Of 28 patients evaluable for response, 25 patients (89%) achieved CNS complete remission and three (11%) partial remission. The median number of intrathecal LC administrations per patient was 4. The cerebrospinal fluid was cleared after a median of 3 intrathecal LC administrations. Neurological toxicity ≥ grade 3 occurred in four (13%) patients. No permanent sequelae were observed. The median overall survival was 20.9 months and the 5-year probability of survival was 46%. These encouraging data suggest that intrathecal LC is well tolerated and effective in children with relapsed/refractory CNS leukemia/lymphoma.
KW - CNS relapse
KW - Intrathecal liposomal cytarabine
KW - childhood hematological malignancies
KW - neurological adverse events
KW - pediatric acute leukemia
KW - CNS relapse
KW - Intrathecal liposomal cytarabine
KW - childhood hematological malignancies
KW - neurological adverse events
KW - pediatric acute leukemia
UR - https://publicatt.unicatt.it/handle/10807/230039
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84924706327&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84924706327&origin=inward
U2 - 10.3109/10428194.2014.927456
DO - 10.3109/10428194.2014.927456
M3 - Article
SN - 1042-8194
VL - 56
SP - 650
EP - 655
JO - LEUKEMIA & LYMPHOMA
JF - LEUKEMIA & LYMPHOMA
IS - 3
ER -