title: Toxicity and efficacy of intrathecal liposomal cytarabine in children with leukemia/lymphoma relapsing in the central nervous system: a retrospective multicenter study.
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.
authors.affiliation: Department of Pediatric Hematogy-Oncology, Santobono-Pausilipon Hospital , Naples , Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Parasole
authors.forename: Fara
authors.initials: F
authors.lastname: Petruzziello
authors.forename: Chiara
authors.initials: C
authors.lastname: Messina
authors.forename: Elena
authors.initials: E
authors.lastname: Barisone
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Concetta
authors.initials: C
authors.lastname: Micalizzi
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Testi
authors.forename: Antonia
authors.initials: A
authors.lastname: De Matteo
authors.forename: Stefania
authors.initials: S
authors.lastname: Varotto
authors.forename: Massimo
authors.initials: M
authors.lastname: Berger
authors.forename: William
authors.initials: W
authors.lastname: Morello
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Menna
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Poggi
mesh_terms: D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007278:Injections, Spinal; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008081:Liposomes; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000964:Antimetabolites, Antineoplastic; D008081:Liposomes; D003561:Cytarabine
keywords: CNS relapse; Intrathecal liposomal cytarabine; childhood hematological malignancies; neurological adverse events; pediatric acute leukemia