Phase 2 study of intrathecal, long-acting liposomal cytarabine in the prophylaxis of lymphomatous meningitis in human immunodeficiency virus-related non-Hodgkin lymphoma

Michele Spina, Emanuela Chimienti, Ferdinando Martellotta, Emanuela Vaccher, Massimiliano Berretta, Ernesto Zanet, Arben Lleshi, Vincenzo Canzonieri, Pietro Bulian, Umberto Tirelli

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Patients with aggressive non-Hodgkin lymphoma (NHL) develop central nervous system (CNS) progression or recurrence during the course of their disease. Patients with human immunodeficiency virus (HIV)-NHL often develop CNS progression despite the use of prophylaxis. Liposomal cytarabine (DepoCyte) has shown activity in lymphomatous meningitis, but there are limited data for prophylaxis. METHODS: Between May 2006 and December 2008, a phase 2 study of intrathecal liposomal cytarabine was performed at the dose of 50 mg in 30 patients with HIV-NHL, with the aim of evaluating feasibility and activity for prophylaxis. RESULTS: Liposomal cytarabine was well tolerated, with headache grade I to III being the most frequent side effect in 40% of patients. With a median followup of 10.5 months, only 1 (3%) patient developed a combined systemic and meningeal recurrence. The use of liposomal cytarabine allowed significant reduction of the number of lumbar injections in comparison to the standard schedules (around 50%), improving the quality of life of patients and reducing the professional exposure risk. CONCLUSIONS: In this first study on prophylaxis of lymphomatous meningitis in HIV-NHL, liposomal cytarabine seems safe and active; it reduces by approximately 50% the number of lumbar punctures, and exposure risk for health staff as well.

Original languageEnglish
Pages (from-to)1495-1501
Number of pages7
JournalCancer
Volume116
Issue number6
DOIs
Publication statusPublished - Mar 15 2010

Keywords

  • Human immunodeficiency virus infection
  • Liposomal cytarabine
  • Non-Hodgkin lymphoma
  • Prophylaxis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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