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Byrnes DM, Vargas F, Dermarkarian C, et al. Complications of Intrathecal Chemotherapy in Adults: Single-Institution Experience in 109 Consecutive Patients. J Oncol. 2019;2019:4047617doi: 10.1155/2019/4047617.
Byrnes, D. M., Vargas, F., Dermarkarian, C., Kahn, R., Kwon, D., Hurley, J., & Schatz, J. H. (2019). Complications of Intrathecal Chemotherapy in Adults: Single-Institution Experience in 109 Consecutive Patients. Journal of oncology, 20194047617. https://doi.org/10.1155/2019/4047617
Byrnes, Diana M, et al. "Complications of Intrathecal Chemotherapy in Adults: Single-Institution Experience in 109 Consecutive Patients." Journal of oncology vol. 2019 (2019): 4047617. doi: https://doi.org/10.1155/2019/4047617
Byrnes DM, Vargas F, Dermarkarian C, Kahn R, Kwon D, Hurley J, Schatz JH. Complications of Intrathecal Chemotherapy in Adults: Single-Institution Experience in 109 Consecutive Patients. J Oncol. 2019 May 02;2019:4047617. doi: 10.1155/2019/4047617. eCollection 2019. PMID: 31186634; PMCID: PMC6521528.
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J Oncol. 2019 May 02;2019:4047617. doi: 10.1155/2019/4047617. eCollection 2019.

Complications of Intrathecal Chemotherapy in Adults: Single-Institution Experience in 109 Consecutive Patients.

Journal of oncology

Diana M Byrnes, Fernando Vargas, Christopher Dermarkarian, Ryan Kahn, Deukwoo Kwon, Judith Hurley, Jonathan H Schatz

Affiliations

  1. Hematology-Oncology Fellowship Program, Department of Medicine, Jackson Memorial Hospital, USA.
  2. Miami Cancer Institute, Baptist Health South Florida, USA.
  3. University of Miami Miller School of Medicine, USA.
  4. Biostatistics and Bioinformatics Core, USA.
  5. Sylvester Comprehensive Cancer Center, USA.
  6. Division of Hematology, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.

PMID: 31186634 PMCID: PMC6521528 DOI: 10.1155/2019/4047617

Abstract

Acute lymphoblastic leukemia and other aggressive lymphoid malignancies like Burkitt leukemia/lymphoma have high incidence of central nervous system (CNS) involvement. Various solid tumors, most notably breast cancer, can also metastasize into the CNS as a late stage complication causing devastating effects. Intrathecal (IT) chemotherapy consisting of methotrexate, cytarabine, or the two in combination is frequently used for the prophylaxis and treatment of CNS metastasis. Because of the high toxicity of these chemotherapeutic agents, however, their side effect profiles are potentially catastrophic. The incidence of neurotoxicity secondary to IT chemotherapy is well defined in the pediatric literature but is poorly reported in adults. Here, we investigated the incidence of neurologic and nonneurologic side effects secondary to IT chemotherapy in 109 consecutive adult patients over a two-year time period at hospitals associated with our institution. Of 355 IT chemotherapy treatments received by these patients, 11 (3.10%) resulted in paresthesias or paralysis, which we defined as significant neurologic events in our analysis. We also examined minor events that arose after IT chemotherapy, including back pain, headache, fever, vomiting, and asthenia. At least one of these occurred after 30.70% of IT chemotherapy doses. Clinicians involved in the care of patients receiving IT chemotherapy should be aware of these findings and consider treatment options lower rate of neurotoxicity such as high-dose systemic methotrexate.

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