title: Liposomal cytarabine in the prophylaxis and treatment of CNS lymphoma: toxicity analysis in a retrospective case series study conducted at Polish Lymphoma Research Group Centers.
abstract: Lymphomas with primary or secondary involvement of central nervous system (CNS) have poor prognosis despite specific treatment protocols which include whole brain radiotherapy and high-dose systemic and/or intrathecal chemotherapy. Toxicity of intrathecal liposomal cytarabine-based regimens collected between November 2006 and January 2012 was assessed retrospectively. Data from 120 adult lymphoma patients with, or at high risk of CNS involvement who received intrathecal liposomal cytarabine-based regimens at six Polish Lymphoma Research Group centres between November 2006 and January 2012 were assessed retrospectively. Patients were divided into three cohorts: A (high risk of CNS disease, n = 88), B (cerebrospinal fluid pleocytosis without neurological symptoms or pathological imaging findings, n = 7), and C (CNS disease/neurological involvement; n = 25). In all examined groups, toxicity of treatment was found to be acceptable (including the prophylactic setting). None of the patients in cohorts A or B who took intrathecal liposomal cytarabine 50 mg, repeated every 2-4 weeks (mean 3.8 doses) had experienced a CNS relapse at a median follow-up time of 3 years. Patients in cohort C had a 76 % overall neurological response rate (including a 40 % complete response rate) and median overall survival of 4.8 years. Regimens incorporating liposomal cytarabine seem to be safe and effective treatments for lymphomas with CNS involvement.
authors.affiliation: Department of Haematology, Jagiellonian University, 36 Kopernika str., 30-501, Kraków, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jurczak
authors.forename: Renata
authors.initials: R
authors.lastname: Kroll-Balcerzak
authors.forename: Sebastian
authors.initials: S
authors.lastname: Giebel
authors.forename: Maciej
authors.initials: M
authors.lastname: Machaczka
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Giza
authors.forename: Tomasz
authors.initials: T
authors.lastname: Ogórka
authors.forename: Szymon
authors.initials: S
authors.lastname: Fornagiel
authors.forename: Justyna
authors.initials: J
authors.lastname: Rybka
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wróbel
authors.forename: Beata
authors.initials: B
authors.lastname: Kumiega
authors.forename: Aleksander B
authors.initials: AB
authors.lastname: Skotnicki
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Komarnicki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003561:Cytarabine / Q000008:administration & dosage*; D004337:Drug Carriers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007278:Injections, Spinal; D008081:Liposomes / Q000008:administration & dosage*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D004337:Drug Carriers; D008081:Liposomes; D003561:Cytarabine