Journal of Neuro-Oncology

, Volume 139, Issue 1, pp 117–123 | Cite as

Efficacy of intrathecal chemotherapy in patients with central nervous system involvement of hematological malignancies: a retrospective analysis

  • A. Dara
  • B. B. Mook
  • J. K. Doorduijn
  • M. J. van den Bent
  • A. G. Dinmohamed
  • J. E. C. Bromberg
Clinical Study



Central nervous system (CNS) involvement, especially involvement of the cerebrospinal fluid (CSF), is common in several haematological malignancies. Intrathecal (IT) chemotherapy can be used to manage CSF involvement.


Here we evaluated the effectiveness of IT chemotherapy among 80 patients with haematological malignancies and CSF localization who were treated with IT chemotherapy from 2001 to 2012.


The majority of patients was diagnosed with diffuse large B-cell lymphoma (26%) or acute lymphoblastic leukaemia/lymphoblastic lymphoma (19%). After first-line IT chemotherapy, which mainly consisted of methotrexate (MTX) and corticosteroids, CSF complete response (CSF CR) was achieved in 76% of patients. 91% reached CSF CR when including second-line IT-chemotherapy. Clinical response was documented in 75%. Although most patients were additionally treated with systemic chemotherapy, response rate did not differ between patients treated with CNS-penetrating and CNS-non-penetrating drugs. CNS progression/relapse occurred in 40% of patients with median progression-free survival of 12.2 months. The median overall survival was 18.3 months; 55% of the patients died during follow-up.


Our analysis shows a high response rate after first-line IT chemotherapy, but also a relatively high progression/relapse percentage.


Intrathecal chemotherapy Hematological malignancies Methotrexate Cerebrospinal fluid 


Compliance with ethical standards

Conflict of interest

All authors report no conflict of interest.

Supplementary material

11060_2018_2849_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 13 KB)


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyHaga Teaching HospitalDen HaagThe Netherlands
  2. 2.Department of Hematology, Erasmus MC Cancer InstituteUniversity Medical Center RotterdamRotterdamThe Netherlands
  3. 3.Department of Neuro-oncology, Erasmus MC Cancer InstituteUniversity Medical CenterRotterdamThe Netherlands
  4. 4.Department of NeurologyReinier de Graaf HospitalDelftThe Netherlands
  5. 5.Department of ResearchNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
  6. 6.Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands

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