Toxicity and efficacy of intrathecal liposomal cytarabine in children with leukemia/lymphoma relapsing in the central nervous system: A retrospective multicenter study

Rosanna Parasole, Fara Petruzziello, Chiara Messina, Elena Barisone, Andrea Pession, Franco Locatelli, Concetta Micalizzi, Simone Cesaro, Anna Maria Testi, Antonia De Matteo, Stefania Varotto, Massimo Berger, William Morello, Giuseppe Menna, Vincenzo Poggi

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)650-655
Number of pages6
JournalLeukemia and Lymphoma
Volume56
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

Keywords

  • childhood hematological malignancies
  • CNS relapse
  • Intrathecal liposomal cytarabine
  • neurological adverse events
  • pediatric acute leukemia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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