title: Intrathecal liposomal cytarabine (lipoCIT) administration in patients with leukemic or lymphomatous meningitis: efficacy and long-term safety in a single institution.
abstract: BACKGROUND
  There is limited information regarding the efficacy and long term safety of intrathecal injection of liposomal cytarabine in leukemic or lymphomatous meningitis.
  
  
  METHODS
  We studied 20 consecutive HIV-negative patients with leukemic or lymphomatous meningitis who were treated with intrathecal liposomal cytarabine between 2004 and 2007. We focused on efficacy and on any late effects of the drug.
  
  
  RESULTS
  Twenty patients who received intrathecal liposomal cytarabine injection as part of their treatment; of these, 9 were alive and in complete remission at the end of the study. Median survival from the time of the first injection was 22.7 months (range, 0.5 to 64 months). Short-term toxicity related to intrathecal of liposomal cytarabine was observed in 2 cases; headache in 1 case and regressive facial palsy and diplopy in 1 case. Long-term toxicity was seen in 2 cases; clinical symptoms were urinary and fecal dysfunction with confusion in 1 case, and urinary dysfunction in 1 case. Both patients had been heavily pre-treated with neurotoxic drugs and neuraxis irradiation.
  
  
  CONCLUSIONS
  In our experience, intrathecal liposomal cytarabine injections were convenient in the management of leukemic and lymphomatous meningitis, and can lead to long-term survival. Although neurotoxicity was rare, clinicians should exercise caution when retreatment is required in relapsing patients.
authors.affiliation: Centre hospitalier universitaire, Service d'Hématologie, Besançon 25030, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Brion
authors.forename: Faezeh
authors.initials: F
authors.lastname: Legrand
authors.forename: Fabrice
authors.initials: F
authors.lastname: Larosa
authors.forename: Françoise
authors.initials: F
authors.lastname: Schillinger
authors.forename: Francine
authors.initials: F
authors.lastname: Garnache-Ottou
authors.forename: Philippe
authors.initials: P
authors.lastname: Helias
authors.forename: Jean
authors.initials: J
authors.lastname: Fontan
authors.forename: Marian
authors.initials: M
authors.lastname: Heczko
authors.forename: Philippe
authors.initials: P
authors.lastname: Delaby
authors.forename: Etienne
authors.initials: E
authors.lastname: Daguindau
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Vuillier
authors.forename: Adrien
authors.initials: A
authors.lastname: Chauchet
authors.forename: Eric
authors.initials: E
authors.lastname: Deconinck
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007938:Leukemia / Q000188:drug therapy*; D008081:Liposomes / Q000737:chemistry; D008223:Lymphoma / Q000188:drug therapy*; D008297:Male; D008577:Meningeal Neoplasms / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D008081:Liposomes; D003561:Cytarabine