Evidence map›Paper›PMID 28665999›Full record

ArticlePloS one2017

Analysis of the role of intratecal liposomal cytarabine in the prophylaxis and treatment of central nervous system lymphomatosis: The Balearic Lymphoma Group experience.

Marta García-Recio, Antonia Cladera, Leyre Bento, Julia Dominguez, Silvia Ruiz de Gracia, Francesca Sartori, Raquel Del Campo, Lucia García, Carmen Ballester, Jordi Gines and 3 more

Abstract readMulticenter Study
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Intrathecal drug delivery in the era of nanomedicine.Advanced drug delivery reviews · 2020
    Pooled it
  3. Trial
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Marta García-RecioHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Antonia CladeraHematology department, Hospital Son Llatzer, Palma de Mallorca, Balearic Islands, Spain.
Leyre BentoHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Julia DominguezHematology department, Hospital Son Llatzer, Palma de Mallorca, Balearic Islands, Spain.
Silvia Ruiz de GraciaHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Francesca SartoriHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Raquel Del CampoHematology department, Hospital Son Llatzer, Palma de Mallorca, Balearic Islands, Spain.
Lucia GarcíaHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Carmen BallesterHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Jordi GinesPharmacy department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Joan BargayHematology department, Hospital Son Llatzer, Palma de Mallorca, Balearic Islands, Spain.
Antonia SampolHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.
Antonio GutiérrezHematology department, Son Espases University Hospital, Palma de Mallorca, Balearic Islands, Spain.ORCID http://orcid.org/0000-0001-9062-077X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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 non-related (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.

Indexed as

LiposomesAdolescentAdultAgedAged, 80 and overAntimetabolites, AntineoplasticBurkitt LymphomaCentral Nervous System NeoplasmsChildCytarabineFemaleHumansInjections, SpinalMaleMiddle AgedSurvival AnalysisAntimetabolites, AntineoplasticCytarabineLiposomes

Identifiers

PMID28665999
PMCPMC5493300

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.