TY - JOUR
T1 - Toxicity and efficacy of intrathecal liposomal cytarabine in children with leukemia/lymphoma relapsing in the central nervous system
T2 - A retrospective multicenter study
AU - Parasole, Rosanna
AU - Petruzziello, Fara
AU - Messina, Chiara
AU - Barisone, Elena
AU - Pession, Andrea
AU - Locatelli, Franco
AU - Micalizzi, Concetta
AU - Cesaro, Simone
AU - Testi, Anna Maria
AU - De Matteo, Antonia
AU - Varotto, Stefania
AU - Berger, Massimo
AU - Morello, William
AU - Menna, Giuseppe
AU - Poggi, Vincenzo
PY - 2015/3/1
Y1 - 2015/3/1
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 - childhood hematological malignancies
KW - CNS relapse
KW - Intrathecal liposomal cytarabine
KW - neurological adverse events
KW - pediatric acute leukemia
UR - http://www.scopus.com/inward/record.url?scp=84924706327&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924706327&partnerID=8YFLogxK
U2 - 10.3109/10428194.2014.927456
DO - 10.3109/10428194.2014.927456
M3 - Article
C2 - 24882262
AN - SCOPUS:84924706327
VL - 56
SP - 650
EP - 655
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 3
ER -