2026-08-29T16:26:32Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/204342024-11-28T20:00:35Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud
author
Garcia Recio, Marta
author
Cladera-Serra, Antonia
author
Bento, Leyre
author
Dominguez, Julia
author
de Gracia, Silvia Ruiz
author
Sartori, Francesca
author
del Campo Garcia, Raquel
author
Garcia, Lucia
author
Ballester Ruiz, Maria del Carmen
author
Gines, Jordi
author
Bargay Lleonart, Joan
author
Sampol Mayol, Antonia
author
Gutierrez, Antonio
2024-07-11T09:10:33Z
2024-07-11T09:10:33Z
2017-06-30
Garcia Recio M, Cladera Serra A, Bento L, Dominguez J, Ruiz De Gracia S, Sartori F, et al. Analysis of the role of intratecal liposomal cytarabine in the prophylaxis and treatment of central nervous system lymphomatosis: The Balearic Lymphoma Group experience. PLoS One. 2017 Jun 30;12(6):e0179595.
10.1371/journal.pone.0179595
1932-6203
PloS One
http://hdl.handle.net/20.500.13003/9773
28665999
L617025212
2-s2.0-85021656260
http://hdl.handle.net/20.500.12105/20434
404608700036
Central nervous system (CNS) lymphomatosis is a fatal complication of aggressive non-Hodgkin lymphoma (NHL). In lymphoblastic or Burkitt lymphoma, without specific CNS prophylaxis the risk of CNS relapse is 20-30%. DLBCL has a lower risk of relapse (around 5%) but several factors increase its incidence. There is no consensus or trials to conclude which is the best CNS prophylaxis. Best results seem to be associated with the use of intravenous (iv) high-dose methotrexate (HDMTX) but with a significant toxicity. Other options are the administration of intrathecal (IT) MTX, cytarabine or liposomal cytarabine (ITLC). Our aim is to analyze the experience of the centers of the Balearic Lymphoma Group (BLG) about the toxicity and efficacy of ITLC in the prophylaxis and therapy of CNS lymphomatosis. We retrospectively reviewed cases from 2005 to 2015 (n = 58) treated with ITLC. Our toxicity results were: 33% headache, 20% neurological deficits, 11% nausea, 9% dizziness, 4% vomiting, 4% fever, 2% transient blindness and 2% photophobia. In the prophylactic cohort (n = 26) with a median follow-up of 55 months (17-81) only 3 CNS relapses (11%) were observed (testicular DLBCL, Burkitt and plasmablastic lymphoma, with a cumulative incidence of 8%, 14% and 20% respectively). In the treatment cohort (n = 32), CSF complete clearance was obtained in 77% cases. Median OS was 6 months (0-16). Death causes were lymphoma progression (19 patients, 79%), treatment toxicity (2 patients) and nonrelated (3 patients, 12%). Toxicity profile was good especially when concomitant dexamethasone was administered. In the prophylactic cohort the incidence of CNS relapse in DLBCL group was similar to previously reported for HDMTX and much better than IT MTX. A high number of ITLC injections was associated with better rates of CSF clearance, clinical responses, PFS and lower relapses. Survival is still poor in CNS lymphomatosis and new therapeutic approaches are still needed.
eng
Analysis of the role of intratecal liposomal cytarabine in the prophylaxis and treatment of central nervous system lymphomatosis: The Balearic Lymphoma Group experience
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