all intrathecal chemotherapy
Several factors related to intrathecal preparation can affect toxicity. Thus, it was decided to standardize intrathecal chemotherapy, trying to obtain the best toxicity profile. Objective To assess the toxicity of a standardized triple intrathecal chemotherapy in oncohematological pediatric patients and to establish risk factors of toxicity. Chemotherapy drugs in the bloodstream can’t reach the brain and spinal cord. To treat these parts of the body the drugs need to be injected directly into the cerebrospinal fluid. This is done through a lumbar puncture. Giving chemotherapy in this way is called intrathecal chemotherapy. You will have intrathecal chemotherapy even if leukaemia cells can’t be detected in the CSF. This is because research has shown that there is a high risk of leukaemia cells in the CSF. Results A total of 269 administrations of triple intrathecal chemotherapy were registered in 41 patients (mean age = 6.6 ± 3.9 years). In 16.7% of the procedures, an adverse event was reported (total number of adverse events = 61). 47.5% were grade 1, 47.5% grade 2 and 4.9% grade 3. For ALL, chemotherapy may be given into the fluid surrounding the brain and spinal cord. This is called intrathecal chemotherapy. Methods Prospective, descriptive and observational study in which all the administrations of standardized triple intrathecal chemotherapy in pediatric patients were registered. Main outcome measure Toxicity of the intrathecal therapy was recorded and possible risk factors were assessed. The drugs traditionally used in intrathecal chemotherapy are methotrexate and cytarabine. Many authors defend the combined use of methotrexate, cytarabine and glucocorticosteroids, which is called triple intrathecal therapy (TIT). One of the most commonly corticosteroids used in TIT chemotherapy is hydrocortisone. Impacts on practice. 1  The protocolised conditions of preparation and administration described may be useful for different professionals, because although intrathecal chemotherapy is used in most treatment protocols for hematological malignancies. Abstract. 1  Background The administration of triple intrathecal therapy with methotrexate, cytarabine and a corticosteroid for the prophylaxis and treatment of neoplastic cell infiltration in the central nervous system in hematological malignancies is a widespread practice. The administration of intrathecal chemotherapy inpatient and patient age ≥3 years were risk factors of toxicity in the multivariate analysis. Conclusions The administration of Matloub Y, Lindemulder S, Gaynon PS, Sather H, La M, Broxson E, et al. Intrathecal triple therapy decreases central nervous system relapse but fails to improve event free survival when compared with intrathecal methotrexate: results of the Children’s Cancer Group (CCG) 1952 study for standard-risk acute lymphoblastic leukemia, reported by the Children’s Oncology Group.
For acute lymphoblastic leukemia, chemotherapy may be given into the fluid surrounding the brain and spinal cord. This is called intrathecal chemotherapy.