title: Efficacy and safety of intrathecal liposomal cytarabine for the treatment of meningeal relapse in acute lymphoblastic leukemia: experience of two pediatric institutions.
abstract: The treatment of meningeal relapse in acute lymphoblastic leukemia (ALL) remains a challenging clinical problem. Liposomal cytarabine (DepoCyte) permits to decrease frequency of lumbar punctures, without loss of efficacy, because intrathecal levels of the drug remain cytotoxic for up to 14 days. We investigated the efficacy and safety of intrathecal DepoCyte in six children with meningeal relapse, treated in two pediatric institutions. DepoCyte was well tolerated in all patients, who achieved complete clearance of blasts from the cerebrospinal fluid after the first three intrathecal drug administrations. Five of the six patients were concurrently treated with high-dose administration of systemic cytarabine, without additional neurological side effects. Our results suggest that DepoCyte is a valid option for children with ALL experiencing meningeal relapse; it deserves further investigation in intensive treatment regimens, taking into due consideration potential neurotoxicity.
authors.affiliation: Department of Pediatric Hemato-Oncology, Santobono-Pausilipon Hospital, Naples, Italy. rparasol@libero.it
authors.forename: Rosanna
authors.initials: R
authors.lastname: Parasole
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Menna
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Marra
authors.forename: Fara
authors.initials: F
authors.lastname: Petruzziello
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Argia
authors.initials: A
authors.lastname: Mangione
authors.forename: Aldo
authors.initials: A
authors.lastname: Misuraca
authors.forename: Salvatore
authors.initials: S
authors.lastname: Buffardi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Di Cesare-Merlone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Poggi