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Intrathecal liposomal cytarabine (lipoCIT) administration in patients with leukemic or lymphomatous meningitis

Efficacy and long-term safety in a single institution

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Summary

Background There is limited information regarding the efficacy and long term safety of intrathecal injection of liposomal cytarabine in leukemic or lymphomatous meningitis. Design and Methods We studied 20 consecutive HIV-negative patients with leukemic or lymphomatous meningitis who were treated with intrathecal liposomal cytarabine between 2004 and 2007. We focused on efficacy and on any late effects of the drug. Results Twenty patients who received intrathecal liposomal cytarabine injection as part of their treatment; of these, 9 were alive and in complete remission at the end of the study. Median survival from the time of the first injection was 22.7 months (range, 0.5 to 64 months). Short-term toxicity related to intrathecal of liposomal cytarabine was observed in 2 cases; headache in 1 case and regressive facial palsy and diplopy in 1 case. Long-term toxicity was seen in 2 cases; clinical symptoms were urinary and fecal dysfunction with confusion in 1 case, and urinary dysfunction in 1 case. Both patients had been heavily pre-treated with neurotoxic drugs and neuraxis irradiation. Conclusion In our experience, intrathecal liposomal cytarabine injections were convenient in the management of leukemic and lymphomatous meningitis, and can lead to long-term survival. Although neurotoxicity was rare, clinicians should exercise caution when retreatment is required in relapsing patients.

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Acknowledgments

The authors would like to thank San Francisco Edit, Mill Valley, CA 94941 USA, for editing and proofreading of the manuscript.

Authorship and Disclosures

AB takes primary responsibility for the paper. AB, FLe, FLa, PH, JF, MH, AC, PD, EDa, JV and ED recruited the patients. FS and FGO performed the laboratory work for this study. AB and ED wrote the paper. The authors approved the version submitted and every single author can take public responsibility for the content.

The authors report no potential conflicts of interest.

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Correspondence to Eric Deconinck.

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Brion, A., Legrand, F., Larosa, F. et al. Intrathecal liposomal cytarabine (lipoCIT) administration in patients with leukemic or lymphomatous meningitis. Invest New Drugs 30, 1697–1702 (2012). https://doi.org/10.1007/s10637-011-9632-6

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  • DOI: https://doi.org/10.1007/s10637-011-9632-6

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