Show simple item record

dc.contributor.authorLevinsen, Mette
dc.contributor.authorHarila-Saari, Arja
dc.contributor.authorGrell, Kathrine
dc.contributor.authorJonsson, Olafur Gisli
dc.contributor.authorTaskinen, Mervi
dc.contributor.authorAbrahamsson, Jonas
dc.contributor.authorVettenranta, Kim
dc.contributor.authorÅsberg, Ann
dc.contributor.authorRisteli, Juha
dc.contributor.authorHeldrup, Jesper
dc.contributor.authorSchmiegelow, Kjeld
dc.date.accessioned2016-10-31T15:09:28Z
dc.date.available2016-10-31T15:09:28Z
dc.date.issued2016-11
dc.date.submitted2016
dc.identifier.citationEfficacy and Toxicity of Intrathecal Liposomal Cytarabine in First-line Therapy of Childhood Acute Lymphoblastic Leukemia. 2016, 38 (8):602-609 J. Pediatr. Hematol. Oncol.en
dc.identifier.issn1536-3678
dc.identifier.pmid27571129
dc.identifier.doi10.1097/MPH.0000000000000642
dc.identifier.urihttp://hdl.handle.net/2336/620049
dc.descriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the pageen
dc.description.abstractWe investigated efficacy and toxicity of replacing conventional triple (cytarabine, methotrexate, and hydrocortisone) intrathecal therapy (TIT) with liposomal cytarabine during maintenance therapy among 40 acute lymphoblastic leukemia patients. Twenty-eight of 29 patients in the TIT arm received TIT and 9/11 in the liposomal cytarabine arm received liposomal cytarabine. Arachnoiditis occurred in all initial 5 patients given liposomal cytarabine and intrathecal prednisolone succinate. Subsequently liposomal cytarabine was given with systemic dexamethasone. Neurotoxicity occurred at 6/27 liposomal cytarabine administrations with concomitant dexamethasone (22%). More liposomal cytarabine-treated patients experienced neurotoxicity in relation to intrathecal therapy during at least 1 cycle compared with TIT-treated patients (6/9 [67%] vs. 3/28 [11%], P=0.002). Apart from intermittent lower extremity sensory pain in 1 liposomal cytarabine-treated patient, no permanent adverse neurological sequelae were observed. In intention-to-treat analysis, projected 5-year event-free survival (pEFS-5y) was borderline higher for patients in the liposomal cytarabine arm compared with the TIT arm (1.0 vs. 0.69, P=0.046). However, pEFS-5y and projected 5-year relapse-free survival did not differ signficantly between patients treated with liposomal cytarabine or TIT (1.0 vs. 0.73, P=0.10; 1.0 vs. 0.76, P=0.12). Larger prospective trials are needed to explore whether liposomal cytarabine should be used as first-line prevention of relapse.
dc.languageENG
dc.language.isoenen
dc.publisherWolters Kluwer Health | Lippincott Williams & Wilkinsen
dc.relation.urlhttp://dx.doi.org/ 10.1097/MPH.0000000000000642en
dc.relation.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=&AN=00043426-201611000-00003&PDF=yen
dc.rightsArchived with thanks to Journal of pediatric hematology/oncologyen
dc.subjectBráðahvítblæðien
dc.subjectLyfjameðferðen
dc.subjectPED12
dc.subject.meshCytarabine/therapeutic use*en
dc.subject.meshHydrocortisoneen
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy*en
dc.subject.meshMethotrexateen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshLiposomesen
dc.subject.meshNeurotoxicity Syndromesen
dc.titleEfficacy and Toxicity of Intrathecal Liposomal Cytarabine in First-line Therapy of Childhood Acute Lymphoblastic Leukemia.en
dc.typeArticleen
dc.contributor.department1*Department of Paediatrics and Adolescent Medicine, The University Hospital Rigshospitalet ‡Section of Biostatistics, Department of Public Health ‡‡The Institute of Clinical medicine, The Faculty of Medicine, University of Copenhagen, Copenhagen, Denmark †Department of Pediatrics, Astrid Lindgrens Hospital, Stockholm ¶Department of Pediatrics, Institution of Clinical Sciences, Sahlgrenska University Hospital, Gothenburg ††Department of Pediatrics, Skåne University Hospital, Lund, Sweden §Department of Pediatrics, Landspitali University Hospital, Reykjavík, Iceland ∥Division of Hematology-Oncology and Stem Cell Transplantation, Children and Adolescents, Helsinki **Department of Clinical Chemistry, Institute of Diagnostics, University of Oulu, Oulu, Finland #Department of Pediatrics, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway, NY.en
dc.identifier.journalJournal of pediatric hematology/oncologyen
dc.rights.accessLandspitali Access - LSH-aðganguren
html.description.abstractWe investigated efficacy and toxicity of replacing conventional triple (cytarabine, methotrexate, and hydrocortisone) intrathecal therapy (TIT) with liposomal cytarabine during maintenance therapy among 40 acute lymphoblastic leukemia patients. Twenty-eight of 29 patients in the TIT arm received TIT and 9/11 in the liposomal cytarabine arm received liposomal cytarabine. Arachnoiditis occurred in all initial 5 patients given liposomal cytarabine and intrathecal prednisolone succinate. Subsequently liposomal cytarabine was given with systemic dexamethasone. Neurotoxicity occurred at 6/27 liposomal cytarabine administrations with concomitant dexamethasone (22%). More liposomal cytarabine-treated patients experienced neurotoxicity in relation to intrathecal therapy during at least 1 cycle compared with TIT-treated patients (6/9 [67%] vs. 3/28 [11%], P=0.002). Apart from intermittent lower extremity sensory pain in 1 liposomal cytarabine-treated patient, no permanent adverse neurological sequelae were observed. In intention-to-treat analysis, projected 5-year event-free survival (pEFS-5y) was borderline higher for patients in the liposomal cytarabine arm compared with the TIT arm (1.0 vs. 0.69, P=0.046). However, pEFS-5y and projected 5-year relapse-free survival did not differ signficantly between patients treated with liposomal cytarabine or TIT (1.0 vs. 0.73, P=0.10; 1.0 vs. 0.76, P=0.12). Larger prospective trials are needed to explore whether liposomal cytarabine should be used as first-line prevention of relapse.


This item appears in the following Collection(s)

Show simple item record