The use of Ommaya reservoirs to deliver central nervous system directed chemotherapy in childhood acute lymphoblastic leukaemia

Wilson, R., Osborne, C. and Halsey, C. (2018) The use of Ommaya reservoirs to deliver central nervous system directed chemotherapy in childhood acute lymphoblastic leukaemia. Pediatric Drugs, 20(4), pp. 293-301. (doi: 10.1007/s40272-018-0298-9) (PMID:29850985)

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Abstract

Prophylactic eradication of central nervous system (CNS) leukaemia is the current standard of care in treating childhood acute lymphoblastic leukaemia (ALL). This is conventionally achieved through regular lumbar punctures with intrathecal injections of methotrexate into the cerebrospinal fluid (CSF). Ommaya reservoirs are subcutaneous implantable devices that provide a secure route of drug delivery into the CSF via an intraventricular catheter. They are an important alternative in cases where intrathecal injection via lumbar puncture is difficult. Among UK Paediatric Principal Treatment centres for ALL we found considerable variation in methotrexate dosing when using an Ommaya reservoir. We review the current safety and theoretical considerations when using Ommaya reservoirs and evidence for methotrexate dose adjustments via this route. We conclude by summarising the pragmatic consensus decision to use 50% of the conventional intrathecal dose of methotrexate when it is administered via Ommaya reservoir in front-line ALL therapy.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wilson, Dr Ruairi and Halsey, Professor Chris
Authors: Wilson, R., Osborne, C., and Halsey, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Pediatric Drugs
Publisher:Springer
ISSN:1174-5878
ISSN (Online):1179-2019
Published Online:31 May 2018
Copyright Holders:Copyright © 2018 Springer International Publishing AG, part of Springer Nature
First Published:First published in Pediatric Drugs 20(4): 293-301
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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