Skuteczność liposomalnej cytarabiny w leczeniu pierwotnego i wtórnego zajęcia ośrodkowego układu nerwowego w przebiegu chłoniaków nieziarniczych – ocena retrospektywna pacjentów leczonych w Klinice Hematologii UJ CM

Abstract

Intrathecally-administered liposomal cytarabine (DepoCyte – slow release formula) is an efficient way of treatment in primary and secondary central nervous system (CNS) involvement in patients with non-Hodgkin lymphoma. Thirty-six patients with CNS lymphoma were analyzed. Median age was 48 years (18–73). There were 18 males and 18 females.In patients with lymphoma infiltrations circumscribed to cerebro-spinal fluid, intrathecal liposomal cytarabine alone allowed for 100% responses, with concomitant improvement of performance status (as assessed by Karnofsky score). None of the patients relapsed in CNS within an average observation time of 28 months.Intrathecal liposomal cytarabine combined with whole brain radiotherapy or/and CNS-penetrating chemotherapy allowed to obtain 85.7% cytological responses (90.9% in patients with primary CNS lymphoma): 50% CR and 28.6% PR. Patient's general status improved in 50% of patients.The treatment was well tolerated. Most of the associated adverse events (AE) were mild and moderate (grade 1–2 according to CTCAE); only 5.6% of AE were considered as severe. Headache was the most common complication; whereas cauda equina syndrome was considered as potentially the most dangerous condition. Transient cauda equina syndrome was observed in 1 patient (2.8% of all AEs).