Characteristics of patients experiencing a severe neurologic event after IT liposomal cytarabine and hyper-CVAD
| Parameter . | Patient no. . | ||||
|---|---|---|---|---|---|
| 1 . | 2 . | 3 . | 4 . | 5 . | |
| Age, y | 22 | 19 | 42 | 65 | 54 |
| Sex | M | F | F | M | M |
| CNS risk* | Indeterminate | High | High | High | High |
| No. of courses before toxicity | 2 | 4 | 4 | 2 | 2 |
| Total IT treatments before toxicity | 3 | 6 | 6 | 3 | 3 |
| Time from IT to toxicity, d | 10 | 14 | 1 | 10 | 5 |
| Toxicity | Seizure | Pseudotumor cerebri | Cauda equina syndrome | Cauda equina syndrome | Encephalitis |
| Evaluation | Negative | Increased CSF pressure | Sacral multi-root thickening | Negative | Scattered infarcts or necrosis |
| Toxicity outcome | Resolved | Decreased visual acuity | Persistent fecal incontinence | Persistent fecal and urinary incontinence | Death |
| Last follow-up status | CR | CR | CR | CR | Died in CR |
| Time of follow-up, mo, diagnosis/toxicity | 11/9 | 13/9 | 8/5 | 14/11 | 3/1 |
| Parameter . | Patient no. . | ||||
|---|---|---|---|---|---|
| 1 . | 2 . | 3 . | 4 . | 5 . | |
| Age, y | 22 | 19 | 42 | 65 | 54 |
| Sex | M | F | F | M | M |
| CNS risk* | Indeterminate | High | High | High | High |
| No. of courses before toxicity | 2 | 4 | 4 | 2 | 2 |
| Total IT treatments before toxicity | 3 | 6 | 6 | 3 | 3 |
| Time from IT to toxicity, d | 10 | 14 | 1 | 10 | 5 |
| Toxicity | Seizure | Pseudotumor cerebri | Cauda equina syndrome | Cauda equina syndrome | Encephalitis |
| Evaluation | Negative | Increased CSF pressure | Sacral multi-root thickening | Negative | Scattered infarcts or necrosis |
| Toxicity outcome | Resolved | Decreased visual acuity | Persistent fecal incontinence | Persistent fecal and urinary incontinence | Death |
| Last follow-up status | CR | CR | CR | CR | Died in CR |
| Time of follow-up, mo, diagnosis/toxicity | 11/9 | 13/9 | 8/5 | 14/11 | 3/1 |
The diagnosis, induction response, and last chemotherapy for all 5 patients was pre-B ALL, CR, and MTX + ara-C (methotrexate, cytarabine), respectively.
IT indicates intrathecal; M, male; F, female; CSF, cerebrospinal fluid; and CR, complete remission.
Total planned IT chemotherapy treatments by risk: low 3, indeterminate/high 6, Burkitt 10.