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Article: Intrathecal chemotherapy for hematologic malignancies: Drugs and toxicities

TitleIntrathecal chemotherapy for hematologic malignancies: Drugs and toxicities
Authors
Issue Date2009
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00277/index.htm
Citation
Annals Of Hematology, 2009, v. 88 n. 3, p. 193-201 How to Cite?
AbstractIntrathecal (IT) chemotherapy is an important component of the prophylaxis or treatment of hematologic malignancies in the central nervous system (CNS), especially in patients with acute lymphoblastic leukemia and aggressive lymphomas. Different regimens of IT chemotherapies have been formulated, often in conjunction with systemic high-dose chemotherapy leading to penetration of the drugs into the cerebrospinal fluid (CSF). The three commonest IT drugs are methotrexate, cytosine arabinoside (Ara-C), and corticosteroids. The CSF half-lives of methotrexate and Ara-C are much prolonged, a factor to be considered if these drugs are also administered systemically in high doses. Neurotoxicities attributed to IT chemotherapy have been reported, including spinal cord lesions, seizures, and encephalopathy. Spinal cord lesions, manifesting as tetraplegia, paraplegia, and cauda equina syndrome, are the commonest neurotoxicity. It is mostly related to combined IT methotrexate and Ara-C, or Ara-C as the sole IT agent when given at high doses or as a slow-release preparation. Cord lesions rarely recover and patients are left with motor deficits, bowel and urinary disabilities. Seizures and encephalopathy are reported in relatively fewer patients, with variable manifestations and prognosis. Knowledge of the pharmacokinetics, dosing schedules and potential toxicities of IT chemotherapeutic drugs is important in the design of CNS prophylaxis and treatment in hematologic malignancies. © Springer-Verlag 2008.
Persistent Identifierhttp://hdl.handle.net/10722/125096
ISSN
2015 Impact Factor: 3.022
2015 SCImago Journal Rankings: 1.117
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorYeung, DYMen_HK
dc.contributor.authorChan, JCWen_HK
dc.date.accessioned2010-10-31T11:11:08Z-
dc.date.available2010-10-31T11:11:08Z-
dc.date.issued2009en_HK
dc.identifier.citationAnnals Of Hematology, 2009, v. 88 n. 3, p. 193-201en_HK
dc.identifier.issn0939-5555en_HK
dc.identifier.urihttp://hdl.handle.net/10722/125096-
dc.description.abstractIntrathecal (IT) chemotherapy is an important component of the prophylaxis or treatment of hematologic malignancies in the central nervous system (CNS), especially in patients with acute lymphoblastic leukemia and aggressive lymphomas. Different regimens of IT chemotherapies have been formulated, often in conjunction with systemic high-dose chemotherapy leading to penetration of the drugs into the cerebrospinal fluid (CSF). The three commonest IT drugs are methotrexate, cytosine arabinoside (Ara-C), and corticosteroids. The CSF half-lives of methotrexate and Ara-C are much prolonged, a factor to be considered if these drugs are also administered systemically in high doses. Neurotoxicities attributed to IT chemotherapy have been reported, including spinal cord lesions, seizures, and encephalopathy. Spinal cord lesions, manifesting as tetraplegia, paraplegia, and cauda equina syndrome, are the commonest neurotoxicity. It is mostly related to combined IT methotrexate and Ara-C, or Ara-C as the sole IT agent when given at high doses or as a slow-release preparation. Cord lesions rarely recover and patients are left with motor deficits, bowel and urinary disabilities. Seizures and encephalopathy are reported in relatively fewer patients, with variable manifestations and prognosis. Knowledge of the pharmacokinetics, dosing schedules and potential toxicities of IT chemotherapeutic drugs is important in the design of CNS prophylaxis and treatment in hematologic malignancies. © Springer-Verlag 2008.en_HK
dc.languageengen_HK
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00277/index.htmen_HK
dc.relation.ispartofAnnals of Hematologyen_HK
dc.subject.meshAnimalsen_HK
dc.subject.meshAntineoplastic Agents - administration & dosage - adverse effects - toxicityen_HK
dc.subject.meshCytarabine - administration & dosage - adverse effects - toxicityen_HK
dc.subject.meshHematologic Neoplasms - drug therapy - pathologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInjections, Spinalen_HK
dc.subject.meshMethotrexate - administration & dosage - adverse effects - toxicityen_HK
dc.subject.meshNervous System Diseases - chemically induced - pathologyen_HK
dc.titleIntrathecal chemotherapy for hematologic malignancies: Drugs and toxicitiesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0939-5555&volume=88&issue=3&spage=193&epage=201&date=2008&atitle=Intrathecal+chemotherapy+for+hematologic+malignancies:+drugs+and+toxicitiesen_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00277-008-0645-yen_HK
dc.identifier.pmid19050889-
dc.identifier.scopuseid_2-s2.0-59049093838en_HK
dc.identifier.hkuros180777en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-59049093838&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume88en_HK
dc.identifier.issue3en_HK
dc.identifier.spage193en_HK
dc.identifier.epage201en_HK
dc.identifier.isiWOS:000262649700001-
dc.publisher.placeGermanyen_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridYeung, DYM=25722430700en_HK
dc.identifier.scopusauthoridChan, JCW=9940606800en_HK
dc.identifier.citeulike3761289-

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