Goekbuget, Nicola and Hartog, Christina-Maria and Bassan, Renato and Derigs, Heinz-Gerd and Dombret, Herve and Greil, Richard and Hernandez-Rivas, Jesus-Maria and Huguet, Francoise and Intermesoli, Tamara and Jourdan, Eric and Junghanss, Christian and Leimer, Lothar and Moreno, Maria-Jose and Reichle, Albrecht and Ribera, Josep and Schmid, Matthias and Serve, Hubert and Stelljes, Matthias and Stuhlmann, Reingard and Hoelzeri, Dieter (2011) Liposomal cytarabine is effective and tolerable in the treatment of central nervous system relapse of acute lymphoblastic leukemia and very aggressive lymphoma. HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 96 (2). pp. 238-244. ISSN 0390-6078,
Full text not available from this repository. (Request a copy)Abstract
Background Treatment of central nervous system relapse in adult acute lymphoblastic leukemia is a challenge and outcome is poor. Liposomal cytarabine has a prolonged half-life and, given intrathecally, has produced high response rates in patients with central nervous system relapse of non-Hodgkin's lymphoma. The aim of this study was to evaluate the efficacy and tolerability of liposomal cytarabine in central nervous system relapse of acute lymphoblastic leukemia or Burkitt's lymphoma/leukemia. Design and Methods Liposomal cytarabine (50 mg) was given intrathecally together with systemic or intrathecal dexamethasone once every 2 weeks in a phase II European trial. The primary end-point, cytological response in the cerebrospinal fluid after one or two cycles, was evaluated at the time of next treatment. Results Nineteen heavily pretreated patients (median age, 53 years; range 24-76 years) were evaluable: 14 with acute lymphoblastic leukemia and 5 with Burkitt's lymphoma/leukemia). Complete cytological remission as best response after two cycles of liposomal cytarabine was confirmed in 74% of the patients: 86% of those with acute lymphoblastic leukemia and 40% of those with Burkitt's lymphoma/leukemia). Nine of the 14 patients who achieved complete remission relapsed after a median of 7 months. The median overall survival was 11 months. Adverse events were observed in 89% of the patients (57% of cycles). Grade events with potential correlation to liposomal cytarabine occurred in 32% of the patients. The most frequent adverse event was headache. One patient developed severe neurological complications with loss of vision and a conus syndrome. Conclusions Overall, liposomal cytarabine showed excellent antileukemic activity. Toxicity was acceptable but appeared to increase with the number of cycles. Future evaluation in prophylaxis is of interest (ClinicalTrials.gov Identifier:NCT00199108)
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTRATHECAL DEPOT CYTARABINE; ACUTE MYELOID-LEUKEMIA; NEOPLASTIC MENINGITIS; THERAPY; ADULTS; PROPHYLAXIS; TRIAL; COMPLICATIONS; INVOLVEMENT; MENINGOSIS; liposomal cytarabine; acute lymphoblastic leukemia; aggressive lymphoma; CNS relapse; adults |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Jun 2020 07:44 |
| Last Modified: | 26 Jun 2020 07:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21319 |
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