Ommaya reservoir use in pediatric ALL and NHL: a review at St. Jude Children's Research Hospital.

Intraventricular chemotherapy Methotrexate Ommaya reservoir

Journal

Cancer chemotherapy and pharmacology
ISSN: 1432-0843
Titre abrégé: Cancer Chemother Pharmacol
Pays: Germany
ID NLM: 7806519

Informations de publication

Date de publication:
28 Feb 2024
Historique:
received: 26 10 2023
accepted: 11 02 2024
medline: 28 2 2024
pubmed: 28 2 2024
entrez: 28 2 2024
Statut: aheadofprint

Résumé

The intraventricular route of chemotherapy administration, via an Ommaya Reservoir (OmR) improves drug distribution in the central nervous system (CNS) compared to the more commonly used intrathecal administration. We retrospectively reviewed our experience with intraventricular chemotherapy, focused on methotrexate, in patients with Acute Lymphoblastic Leukemia (ALL) and Non-Hodgkin Lymphoma (NHL). Twenty-four patients (aged 7 days - 22.2 years) with 26 OmR placements were identified for a total of 25,009 OmR days between 1990 and 2019. Methotrexate cerebrospinal fluid (CSF) concentrations (n = 124) were analyzed from 59 courses of OmR therapy in 15 patients. Twenty-one courses involved methotrexate dosing on day 0 only, whereas 38 courses involved booster dosing on days 1, 2, or both. We simulated the time CSF methotrexate concentrations remained > 1 µM for 3 days given various dosing regimens. CSF methotrexate exposure was higher in those who concurrently received systemic methotrexate than via OmR alone (p < 10 OmR were able to be safely placed and administer intraventricular methotrexate with and without boost doses in patients from 7 days to 22 years old. Boosting strategies are predicted to increase CSF methotrexate concentrations ≥ 1 µM for 72 h.

Identifiants

pubmed: 38416167
doi: 10.1007/s00280-024-04653-9
pii: 10.1007/s00280-024-04653-9
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : American Lebanese Syrian Associated Charities
ID : American Lebanese Syrian Associated Charities

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Alyssa Gaietto (A)

Department of Pharmacy Services, University of Kentucky Healthcare, Lexington, KY, USA.

John C Panetta (JC)

Department of Pharmacy and Pharmaceutical Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail stop 150, Memphis, TN, 38105, USA.

Jennifer L Pauley (JL)

Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.

Mary V Relling (MV)

Department of Pharmacy and Pharmaceutical Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail stop 150, Memphis, TN, 38105, USA.

Raul Ribeiro (R)

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Matthew J Ehrhardt (MJ)

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Ching-Hon Pui (CH)

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Hiroto Inaba (H)

Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.

Hope D Swanson (HD)

Department of Pharmacy and Pharmaceutical Services, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail stop 150, Memphis, TN, 38105, USA. hope.swanson@stjude.org.

Classifications MeSH