Efficacy of intrathecal chemotherapy in patients with central nervous system involvement of hematological malignancies: a retrospective analysis
Introduction: Central nervous system (CNS) involvement, especially involvement of the cerebrospinal fluid (CSF), is common in several haematological malignancies. Intrathecal (IT) chemotherapy can be used to manage CSF involvement. Methods: Here we evaluated the effectiveness of IT chemotherapy among 80 patients with haematological malignancies and CSF localization who were treated with IT chemotherapy from 2001 to 2012. Results: The majority of patients was diagnosed with diffuse large B-cell lymphoma (26%) or acute lymphoblastic leukaemia/lymphoblastic lymphoma (19%). After first-line IT chemotherapy, which mainly consisted of methotrexate (MTX) and corticosteroids, CSF complete response (CSF CR) was achieved in 76% of patients. 91% reached CSF CR when including second-line IT-chemotherapy. Clinical response was documented in 75%. Although most patients were additionally treated with systemic chemotherapy, response rate did not differ between patients treated with CNS-penetrating and CNS-non-penetrating drugs. CNS progression/relapse occurred in 40% of patients with median progression-free survival of 12.2 months. The median overall survival was 18.3 months; 55% of the patients died during follow-up. Conclusions: Our analysis shows a high response rate after first-line IT chemotherapy, but also a relatively high progression/relapse percentage.
|Keywords||Cerebrospinal fluid, Hematological malignancies, Intrathecal chemotherapy, Methotrexate|
|Persistent URL||dx.doi.org/10.1007/s11060-018-2849-x, hdl.handle.net/1765/105743|
|Journal||Journal of Neuro-Oncology|
Dara, A. (A.), Mook, B.B. (B. B.), Doorduijn, J.K, van den Bent, M.J, Dinmohamed, A.G, & Bromberg, J.E.C. (2018). Efficacy of intrathecal chemotherapy in patients with central nervous system involvement of hematological malignancies: a retrospective analysis. Journal of Neuro-Oncology, 1–7. doi:10.1007/s11060-018-2849-x