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: | Halsey, Professor Chris and Wilson, Dr Ruairi |
| Authors: | Wilson, R., Osborne, C., and Halsey, C. |
| College/School: | College of Medical Veterinary and Life Sciences > School 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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