Liposomal cytarabine for leukemic and lymphomatous meningitis: recent developments

被引:28
作者
Benesch, Martin [1 ]
Urban, Christian [1 ]
机构
[1] Graz Univ, Dept Pediat & Adolescent Med, Div Pediat Hematol Oncol, A-8036 Graz, Austria
关键词
CNS prophylaxis; liposomal cytarabine; lymphomatous meningitis; neurotoxicity; side effect;
D O I
10.1517/14656566.9.2.301
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Liposomal cytarabine (Depocyte (R)) is a sustained-release formulation of cytarabine developed for intrathecal administration, ensuring prolonged cytotoxic drug concentrations of cytarabine in cerebrospinal fluid. Although liposomal cytarabine is increasingly used for the treatment (and prophylaxis) of CNS involvement in patients with leukemia/lymphoma, many of the recently presented clinical trials on liposomal cytarabine were retrospective in nature or used this drug on a compassionate basis. So far, one randomized Phase III study has shown significantly better response rates in patients with lymphomatous meningitis who received liposomal cytarabine compared with free cytarabine. Considerable concerns about the safety of this drug arose from recent observations that liposomal cytarabine might contribute to neurologic side effects when given too closely to high-dose systemic chemotherapy known to penetrate the brain-blood barrier. Superior efficacy of liposomal cytarabine compared with standard intrathecal therapy should be confirmed in prospective clinical trials. Careful adherence with preventive measures might help physicians to minimize side effects possibly related to the administration of liposomal cytarabine.
引用
收藏
页码:301 / 309
页数:9
相关论文
共 61 条
[1]   Clinical significance of central nervous system involvement at diagnosis of pediatric acute myeloid leukemia: a single institution's experience [J].
Abbott, BL ;
Rubnitz, JE ;
Tong, X ;
Srivastava, DK ;
Pui, CH ;
Ribeiro, RC ;
Razzouk, BI .
LEUKEMIA, 2003, 17 (11) :2090-2096
[2]   Liposomal cytarabine in the central nervous system (CNS) prophylaxis of elderly patients with aggressive B-cell Non-Hodgkin's Lymphoma (NHL) and undifferentiated acute leukemia (UAL): Preliminary results of a single-center experience. [J].
Anaclerico, Barbara ;
Bongarzoni, Velia ;
Chierichini, Anna ;
Bartolini, Maurizio ;
Iacovino, Piero ;
Fenu, Susanna ;
Anticoli-Borza, Paola ;
Annino, Luciana .
BLOOD, 2006, 108 (11) :247B-247B
[3]   Feasibility and toxicity of intrathecal liposomal cytarabine in 5 children and young adults with refractory neoplastic meningitis [J].
Benesch, Martin ;
Sovinz, Petra ;
Krammer, Barbara ;
Lackner, Herwig ;
Mann, Georg ;
Schwinger, Wolfgang ;
Gadner, Helmut ;
Urban, Christian .
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, 2007, 29 (04) :222-226
[4]  
Bjorgvinsdottir H, 2006, PEDIAT BLOOD CANC S4, V47, P444
[5]   Incidence and risk factors of central nervous system recurrence in aggressive lymphoma - a survey of 1693 patients treated in protocols of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL) [J].
Boehme, V. ;
Zeynalova, S. ;
Kloess, M. ;
Loeffler, M. ;
Kaiser, U. ;
Pfreundschuh, M. ;
Schmitz, N. .
ANNALS OF ONCOLOGY, 2007, 18 (01) :149-157
[6]   Phase I trial of intrathecal liposomal cytarabine in children with neoplastic meningitis [J].
Bomgaars, L ;
Geyer, JR ;
Franklin, J ;
Dahl, G ;
Park, J ;
Winick, NJ ;
Klenke, R ;
Berg, SL ;
Blaney, SM .
JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (19) :3916-3921
[7]  
Brion A, 2007, HAEMATOL-HEMATOL J, V92, P274
[8]   CSF flow cytometry greatly improves diagnostic accuracy in CNS hematologic malignancies [J].
Bromberg, J. E. C. ;
Breems, D. A. ;
Kraan, J. ;
Bikker, G. ;
van der Holt, B. ;
Smitt, P. Sillevis ;
van den Bent, M. J. ;
van't Veer, M. ;
Gratama, J. W. .
NEUROLOGY, 2007, 68 (20) :1674-1679
[9]  
Camera A, 2004, HAEMATOLOGICA, V89, P145
[10]  
Camera A, 2006, BLOOD, V108, p214B