In most patients with acute myeloid leukemia (AML), intrathecal therapy (IT) chemotherapy was efficacious in eliminating cerebrospinal fluid (CSF) blasts and improving neurologic symptoms, according to a study published in Leukemia & Lymphoma. Douglas A. Tremblay, MD, and colleagues assessed outcomes of patients with AML with central nervous system (CNS) involvement. Researchers observed neurologic symptoms in 69% of patients, with headache being the most reported symptom (33%). With a median number of one dose of IT chemotherapy, 84% of patients were able to alleviate CSF. A total of 21% of these patients had a CSF relapse with 67% of those having CSF relapse also experiencing concurrent bone marrow relapse. Of patients with baseline neurologic symptoms, 69% saw improvement in symptoms post-IT therapy. For patients with CNS involvement diagnosed before or during induction and at relapse, median overall survival was 9.3months and 3.5months, respectively. “Few patients experienced CSF relapse, which predominantly occurred in the setting of concomitant bone marrow relapse,” the study authors wrote.
