Efficacy and safety of liposomal cytarabine in lymphoma patients with central nervous system involvement from lymphoma

• Published in: Cancer Vol. 115; no. 9; pp. 1892 - 1898
• Main Authors: Garcia‐Marco, Jose A., Panizo, Carlos, Garcia, Eva Sanchez, Deben, Guillermo, Alvarez‐Larran, Alberto, Barca, Eva Gonzalez, Sancho, Juan Manuel, Penarrubia, Maria Jesus, Garcia‐Cerecedo, Tomas, García‐Vela, Jose A.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-05-2009; Wiley-Blackwell
• Subjects: Adult; Aged; Biological and medical sciences; cytarabine; Cytarabine - administration & dosage; Cytarabine - adverse effects; Cytarabine - therapeutic use; Drug Evaluation; Female; Hematologic and hematopoietic diseases; Humans; injections; Injections, Spinal; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Liposomes; lymphoma; Lymphoma - drug therapy; Lymphoma - pathology; Male; Medical sciences; Meningeal Carcinomatosis - drug therapy; Meningeal Carcinomatosis - secondary; meningeal neoplasms; Middle Aged; Quality of Life; Retrospective Studies; spinal; Tumors; Spain; Antineoplastic agent; Human; injections; Meninge; liposomes; Treatment efficiency; Central nervous system; Liposome; Drug carrier; Malignant hemopathy; Lymphoid neoplasm; Lymphoma; Cancerology; Cytarabine; Antimetabolic; spinal; Lymphoproliferative syndrome; Tumor; meningeal neoplasms; Pyrimidine nucleoside; Cancer
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.24204

BACKGROUND:
Standard intrathecal chemotherapy for lymphomatous meningitis (LM) is limited by the short cerebrospinal half‐lives of the agents used, necessitating frequent administration. Liposomal cytarabine (DepoCyte) has an extended half‐life that permits administration at 2‐ to 4‐weekly intervals.
METHODS:
Patients with LM who underwent treatment with liposomal cytarabine at treatment centers in Spain between 2004 and 2007 were identified. Data on demographics, treatment, and outcomes were extracted from medical notes and entered, retrospectively, into a database for analysis.
RESULTS:
Data on 55 patients with lymphoma (mainly stage IV) and LM were entered into the database. Most patients (n = 36) had diffuse large B‐cell lymphoma. The median number of cycles of liposomal cytarabine received was 4 (range, 1‐10), and the median follow‐up period was 124 days. Complete and partial neurologic responses were achieved in 27 and 12 patients, respectively (overall response rate, 72%), all of whom also showed a cytological response, except for 5 with initially negative cytology. Median time to neurologic progression among responders was 105.5 days. Liposomal cytarabine was generally well tolerated; headache was the most commonly reported adverse effect (n = 17).
CONCLUSIONS:
Liposomal cytarabine is effective and well tolerated in the treatment of LM, and should be considered as an agent of choice for the treatment of this complication. Cancer 2009. © 2009 American Cancer Society.
Liposomal cytarabine (DepoCyte) was used to treat lymphomatous meningitis in a series of 55 patients with lymphoma in Spain. Treatment was associated with a neurologic response rate of 72% and a median time to neurologic progression of 105.5 days.