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Experiences with the ommaya reservoir for prophylaxis and treatment of the central nervous system in adult acute myelocytic leukemia

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Summary

Intraventricular chemotherapy was administered to adult AML patients via an Ommaya reservoir. Twenty-eight patients received central nervous system (CNS) prophylaxis and seven patients were treated for meningeal leukemia (ML). A treatment course lasted at least 6 months. Asymptomatic ML developed in two patients (7%) of the prophylaxis group concomitantly with bone marrow relapse. One of these patients had not completed the standard course. CNS remission could be obtained in all evaluable patients with ML. The easy entrance to the cerebrospinal fluid (CSF) offers the advantage of frequent investigations of the CSF, early diagnosis and treatment of CNS relapses without radiotherapy, and caused little patient discomfort. CNS prophylaxis in this small study seemed to prolong first remission duration slightly. In M4 and M5 subtypes CNS prophylaxis can be valuable.

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References

  1. Ballard JO, Towfighi J, Brennan RW, Saleem S, Eyster EM (1978) Neurologic complications of acute myelomonoblastic leukemia of four years' duration. Neurology 28: 174–178

    Google Scholar 

  2. Blasberg RG (1977) Methotrexate, cytosine arabinoside, and BCNU concentration in brain after ventriculocisternal perfusion. Cancer Treat Rep 61: 625–631

    Google Scholar 

  3. Choi SI, Simone JV (1976) Acute nonlymphocytic leukemia in 171 children. Med Pediatr Oncol 2: 119–146

    Google Scholar 

  4. Dahl GV, Simone JV, Hustu HO, Mason (1978) Preventive central nervous system irradiation in children with acute nonlymphocytic leukemia. Cancer 42: 2187–2192

    Google Scholar 

  5. Dawson DM, Rosenthal DS, Moloney WC (1979) Neurological complications of acute leukemia in adults: changing rate. Ann Intern Med 79: 541–544

    Google Scholar 

  6. Dekker AW, Elderson A, Punt K, Sixma JJ (1985) Meningeal involvement in patients with acute nonlymphocytic leukemia. Cancer 56: 2078–2082

    Google Scholar 

  7. Evans AE, Gilbert Es, Zandstra R (1970) The increasing incidence of central nervous system leukemia in children. Cancer 26: 404–409

    Google Scholar 

  8. Fleming I, Simone JV, Jackson R, Johnson W, Walters T, Mason C (1974) Splenectomy and chemotherapy in acute myelocytic leukemia of childhood. Cancer 33: 427–434

    Google Scholar 

  9. Haaxma-Reiche H, Daenen S (1988) Acute lymphoblastic leukemia in adults: results of intraventricular maintenance chemotherapy for central nervous system prophylaxis and treatment. Eur J Cancer Clin Oncol 24: 615–620

    Google Scholar 

  10. Hénin D, Slabodsky-Brousse N, Renoux M, Dhermy D, Bernard JF (1979) Localisations cérébro-méningées des leucémies aiguës myéloblastiques et des syndromes myéloprolifératifs en acutisation. Nouv Presse Med 8: 751–754

    Google Scholar 

  11. Holmes R, Keating MJ, Cork A, Broach Y, Trujillo J, Dalton WT, McCredie KB, Freireich EJ (1985) A unique pattern of central nervous system leukemia in acute myelomonocytic leukemia associated with inv(16)(p13 q22). Blood 65: 1071–1078

    Google Scholar 

  12. Kay HEM (1976) Development of CNS leukaemia in acute myeloid leukaemia in childhood. Arch Dis Child 51: 73–74

    Google Scholar 

  13. Law IP, Blom J (1977) Adult acute leukemia. Cancer 40: 1304–1306

    Google Scholar 

  14. Meyer RJ, Ferreira PPC, Cuttner J, Greenberg ML, Goldberg J, Holland JF (1980) Central nervous system involvement at presentation in acute granulocytic leukemia. Am J Med 68: 691–694

    Google Scholar 

  15. Pavlovsky S, Eppinger-Heft M, Sackmann Muriel F (1973) Factors that influence the appearance of central nervous system leukemia. Blood 42: 935–938

    Google Scholar 

  16. Peterson BA, Brunning RD, Bloomfield CD, Hurd DD, Gau JA, Peng GT, Goldman AI (1987) Central nervous system involvement in acute nonlymphocytic leukemia Am J Med 83: 464–470

    Google Scholar 

  17. Pippard MJ, Callender ST, Sheldon PWE (1979) Infiltration of central nervous system in adult acute myeloid leukemia. Br Med J I: 227–229

    Google Scholar 

  18. Pluess HJ, Hitzig WH (1980) Die akuten myeloischen Leukaemien im Kindesalter. Schweiz Med W 110: 1459–1462

    Google Scholar 

  19. Price RA (1975) Histopathology of central nervous system leukemia. Mod Probl Paediatr 16: 80–98

    Google Scholar 

  20. Rees JKH, Gray RG, Swirsky D, Hayhoe FGJ (1986) Principal results of the Medical Research Council's 8th acute myeloid leukaemia trial. Lancet II: 1236–1241

    Google Scholar 

  21. Shoenfeld Y, Rothenberg M, Berliner S, Gallant LA, Garfinkel D, Shaklai M, Pinkhas J (1982) Absence of predictive parameters for CNS involvement in adult non-lymphocytic leukaemia at time of diagnosis. Scand J Haematol 28: 335–340

    Google Scholar 

  22. Stewart DJ, Keating MJ, McCredie KB, Smith TL, Youness E, Murphy SG, Bodey GP, Freireich EJ (1981) Natural history of central nervous system acute leukemia in adults. Cancer 47: 184–196

    Google Scholar 

  23. Stewart DJ, Smith TL, Keating MJ, Maor M, Leavens M, Hurtubise M, McCredie KB, Bodey GP, Freireich EJ (1985) Remission from central nervous system involvement in adults with acute leukemia. Cancer 56: 632–641

    Google Scholar 

  24. Tobelem G, Jaquillat C, Chastang C, Auclerc M-F, Lechevallier T, Weil M, Daniel M-T, Flandrin G, Harrousseau J-L, Schaison G, Boiron M, Bernard J (1980) Acute monoblastic leukemia: a clinical and biologic study of 74 cases. Blood 55: 71–76

    Google Scholar 

  25. Walters TR, Aur RJA, Hernandez K, Vietti T, Pinkel D (1972) 6-Azauridine in combination chemotherapy of childhood acute myelocytic leukemia. Cancer 29: 1057–1060

    Google Scholar 

  26. Weizsaecker M, Koelmel HW (1979) Meningeal involvement in leukemias and malignant lymphomas of adults: incidence, course of disease, and treatment for prevention. Acta Neurol Scan 60: 363–370

    Google Scholar 

  27. Wiernik PH, Schimpff SC, Schiffer CA, Lichtenfeld JL, Aisner J, O'Connell MJ, Fortner C (1976) Randomized clinical comparison of daunorubicin (NSC-82151) alone with a combination of daunorubicin, cytosine arabinoside (NSC-63878), 6-thioguanine (NSC-752), and pyrimethamine (NSC-3061) for the treatment of acute nonlymphocytic leukemia. Cancer Treat Rep 60: 41–53

    Google Scholar 

  28. Wolk RW, Masse SR, Conklin R, Freireich EJ (1974) The incidence of central nervous system leukemia in adults with acute leukemia. Cancer 33: 863–869

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University Hospital, Oostersingel 59, NL-9713EZ, Groningen, The Netherlands

    Hanny Haaxma-Reiche & Ron J. W. Witteveen

  2. Department of Hematology, University Hospital, Oostersingel 59, NL-9713EZ, Groningen, The Netherlands

    Simon Daenen

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  1. Hanny Haaxma-Reiche
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  2. Simon Daenen
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  3. Ron J. W. Witteveen
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Haaxma-Reiche, H., Daenen, S. & Witteveen, R.J.W. Experiences with the ommaya reservoir for prophylaxis and treatment of the central nervous system in adult acute myelocytic leukemia. Blut 57, 351–355 (1988). https://doi.org/10.1007/BF00320756

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  • DOI: https://doi.org/10.1007/BF00320756

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