Division of Medical Oncology A, National Cancer Institute, Via Franco Gallini 2, 33081-Aviano (PN) Italy.
Cancer. 2010 Mar 15;116(6):1495-501. doi: 10.1002/cncr.24922.
Patients with aggressive non-Hodgkin lymphoma (NHL) develop central nervous system (CNS) progression or recurrence during the course of their disease. Patients with human immunodeficiency virus (HIV)-NHL often develop CNS progression despite the use of prophylaxis. Liposomal cytarabine (DepoCyte) has shown activity in lymphomatous meningitis, but there are limited data for prophylaxis.
Between May 2006 and December 2008, a phase 2 study of intrathecal liposomal cytarabine was performed at the dose of 50 mg in 30 patients with HIV-NHL, with the aim of evaluating feasibility and activity for prophylaxis.
Liposomal cytarabine was well tolerated, with headache grade I to III being the most frequent side effect in 40% of patients. With a median follow-up of 10.5 months, only 1 (3%) patient developed a combined systemic and meningeal recurrence. The use of liposomal cytarabine allowed significant reduction of the number of lumbar injections in comparison to the standard schedules (around 50%), improving the quality of life of patients and reducing the professional exposure risk.
In this first study on prophylaxis of lymphomatous meningitis in HIV-NHL, liposomal cytarabine seems safe and active; it reduces by approximately 50% the number of lumbar punctures, and exposure risk for health staff as well.
侵袭性非霍奇金淋巴瘤（NHL）患者在疾病过程中会出现中枢神经系统（CNS）进展或复发。尽管使用了预防措施，HIV-NHL 患者仍经常出现 CNS 进展。脂质体阿糖胞苷（DepoCyte）已显示出在淋巴瘤性脑膜炎中的活性，但预防方面的数据有限。
在 2006 年 5 月至 2008 年 12 月期间，对 30 例 HIV-NHL 患者进行了鞘内脂质体阿糖胞苷的 2 期研究，剂量为 50mg，旨在评估预防的可行性和活性。
脂质体阿糖胞苷耐受性良好，40%的患者出现 1-3 级头痛。中位随访 10.5 个月，仅 1 例（3%）患者出现全身和脑膜联合复发。与标准方案相比，脂质体阿糖胞苷的使用显著减少了腰椎注射的次数（约 50%），提高了患者的生活质量，降低了医护人员的职业暴露风险。
在这项 HIV-NHL 脑膜淋巴瘤预防的首次研究中，脂质体阿糖胞苷似乎是安全有效的；它将腰椎穿刺的次数减少了约 50%，同时也降低了医护人员的暴露风险。
