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Use of intrathecal prophylaxis in allogeneic haematopoietic stem cell transplantation for malignant blood diseases: a survey of the European Group for Blood and Marrow Transplantation (EBMT)

Bone Marrow Transplantation volume 35, pages 121–124 (2005)Cite this article

Abstract

Summary:

A survey was carried out among EBMT centres to describe the current practice concerning intrathecal (i.t.) prophylaxis in allogeneic stem cell transplantation for malignant diseases in patients with no central nervous system (CNS) manifestations of the disease at any time. A total of 90 centres reported their practice: 42 centres (47%) never used pre-transplant i.t. prophylaxis as part of the conditioning, whereas 48 centres (53%) gave i.t. prophylaxis to selected groups. The main indications were acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), and lymphoma (53, 33, and 23% of all centres, respectively). Prophylaxis was usually given to all patients with ALL, but often restricted to high-risk patients in AML and lymphoma. Of the 90 centres, 29 (32%) gave prophylactic i.t. treatment after the transplantation, mainly for the same indications as pre-transplant. This survey illustrates the heterogeneity in the current practice of i.t. prophylaxis in allogeneic transplantation for malignant blood disorders in Europe. The documentation in the literature to support the use of i.t. prophylaxis as part of transplantation for malignant diseases in patients without preceding CNS involvement is sparse. Based on the rarity of isolated CNS relapse after allogeneic stem cell transplantation, EBMT does not recommend routine i.t. prophylaxis to patients without prior CNS involvement.

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Acknowledgements

This study was supported in part by the European Commission Sixth Framework Program ‘European LeukemiaNet’.

Author information

Authors and Affiliations

  1. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    T Ruutu

  2. Hematology-Bone Marrow Transplantation Unit, Istituto Nazionale dei Tumori, University of Milan, Milan, Italy

    P Corradini

  3. Division of Hematology, Kantonsspital, Basel, Switzerland

    A Gratwohl

  4. Department of Hematology and Oncology, University of Regensburg, Regensburg, Germany

    E Holler

  5. Department of Haematology, Imperial College School of Medicine, London, UK

    J Apperley

  6. Institute G Gaslini, Genova, Italy

    G Dini

  7. Department of Hematology – Hematopoietic Stem Cell Transplant Unit, Hôpital St Louis, Paris, France

    V Rocha

  8. Department of Hematology, AK St Georg, Hamburg, Germany

    N Schmitz

  9. Department of Hematology, Hôpital St Louis, Paris, France

    G Socié

  10. Division of Haematology & Oncology, University of Leipzig, Leipzig, Germany

    D Niederwieser

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  1. T Ruutu
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  2. P Corradini
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  3. A Gratwohl
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  4. E Holler
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  7. V Rocha
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on behalf of the EBMT

Corresponding author

Correspondence to T Ruutu.

Appendix A

Appendix A

Participating centres:

Austria: Linz, Elisabethinen Hospital (O Krieger, D Lutz); Vienna, AKH (H Greinix), St Anna Kinderspital (S Matthes-Martin).

Belgium: Antwerpen, AZ Stuivenberg (P Zachée), University Hospital Antwerp (J van Droogenbroeck); Brussels, Clinique Universitaire Saint-Luc (A Ferrant), Institut Jules Bordet (A Triffet, D Bron), University Hospital VUB (R Schots, A Willekens); Leuven, University Hospital Gasthuisberg (J Maertens).

Brazil: University Hospital Sao Paulo (F Dulley).

Czech: Hradeck Kralové, Charles University (P Zak, L Jebavy); Pilsen, Charles University Hospital (V Koza).

Finland: Helsinki, University Central Hospital (T Ruutu); Turku, University Central Hospital (K Remes).

France: Besancon, Hôpital Jean Minjoz (J-Y Cahn); Lille, Hôpital Claude Hurjez (JP Jouet); Lyon, Hôpital E. Herriot (M Michallet); Nantes, Hotel Dieu (N Milpied, JL Harousseau).

Germany: Berlin, Univeritätsklinikum Charité-Virchow (R Arnold), Univeritäts-Klinik FU Benjamin Franklin (W Knauf); Düsseldorf, Heinrich Heine Universität (P Schneider), Heinrich Heine Universität, Department of Pediatric Hematology/Oncology (H-J Laws); Freiburg, Universitätsklinik (J Finke); Greifswald, Ernst-Moritz-Arndt Universität (G Dölken); Hamburg, Eppendorf-Krankenhaus (AR Zander); Hannover, Medizinische Hochschule (B Hertenstein); Idar-Oberstein, Klinik für Hämato-Onkologie (N Basara); Leipzig, University of Leipzig (D Niederwieser); Munich, Klinikum Grosshadern (H-J Kolb); Münster, Universitätsklinikum (Pediatrics) (M Paulussen); Regensburg, Universitätsklinikum (E Holler); Universität Rostock (J Casper); Tübingen, Medizinische Univeritätsklinik (H Einsele).

Greece: Athens, Evangelismos Hospital (N Harhalakis); Thessaloniki, George Papanicolaou Hospital (A Fassas).

Israel: Jerusalem, Hadassah University Hospital (MY Shapira); Petach-Tikva, Schneider Children's Medical Center (J Stein).

Italy: Bergamo, Ospedale Riuniti (A Rambaldi); Bologna, St Orsola-Malpighi (G Bandini), St Orsola-Malpighi (Pediatrics) (A Pession); Firenze, Ospedale di Careggi (A Bosi); Genova, G.Gaslini Institute (E Lanino), Ospedale San Martino (A Bacigalupo); Milano, Istituto Nazionale Tumori (P Corradini), Istituto Scientifico HS Raffaele (F Ciceri), Ospedale di Niguarda (P Marenco); University of Perugia (F Aversa); Pesaro, Ospedale San Salvatore (B Erer); Reggio Calabria, Azienda Ospedale Riuniti e Morelli (P Iacopino); San Giovanni Rotondo, Casa Sollievo della Sofferenza (Pediatrics) (P Paolucci); Roma, Università Cattolica (S Sica), University La Sapienza (W Arcese); Torino, University Hospital (F Locatelli, M Falda), University of Torino, Deparment of Pediatrics (F Fagioli);

Netherlands: Leiden, University Medical Centre (R Willemze); Maastricht, University Hospital (HC Schouten); Utrecht, University Hospital (LF Verdonck, R Fijnheer).

Norway: Oslo, Rikshospitalet (L Brinch).

Poland: Lublin, Pediatric Hematology and Oncology Department (JR Kowalczyk); Warsaw, Maria Sklodowska-Curie Memorial Cancer Center (J Walewski).

Russia: Moscow, Research Institute for Pediatric Hematology of Russia (A Maschan); St Petersburg, State Pavlov Medical University (BV Afanassiev).

Slovenia: Ljubljana, University Medical Centre (J Pretnar).

South-Africa: Cape Town, Constantiaberg Medi-Clinic (L Wood).

Spain: Barcelona, Hospital Infantil Vall d’Hebron (J Ortega), Institut Catala d’Oncologia (C Ferra); Madrid, Clinica Puerta de Hierro (MN Fernandez), Hospital Gregorio Marañon (P Balsalobre); Murcia, Hospital Morales Meseguer (JM Moraleda); Pamplona, Clinica Universitaria de Navarra (J Rifon); Santander, Hospital Marqués de Valdecilla (A Iriondo); Valencia, Hospital Universitario La Fe (MA Sanz), Infantil La Fe (A Verdeguer).

Sweden: Gothenburg, Queen Silvia Children's Hospital (A Fasth); Huddinge Hospital (P Ljungman); Lund, University Hospital (S Lenhoff); Uppsala, University Hospital (G Öberg).

Switzerland: Basel, Kantonsspital (A Gratwohl, J Passweg); Geneva, Hopital Cantonal Universitaire (B Chapuis, E Roosnek).

Turkey: Ankara, Ibni Sina Hospital (M Arat); University of Istanbul (S Kalayoglu-Besisik).

UK: Belfast, Royal Victoria Hospital (F Jones); Birmingham, Heartlands Hospital (DW Milligan); Royal Liverpool University Hospital (RE Clark); London, Hammersmith Hospital (J Apperley), King's College Hospital (GJ Mufti), London Clinic (PJ Gravett), Royal Free Hospital (HG Prentice); Nottingham, City Hospital (N Russell); Oxford, John Radcliffe Hospital (TJ Littlewood).

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Ruutu, T., Corradini, P., Gratwohl, A. et al. Use of intrathecal prophylaxis in allogeneic haematopoietic stem cell transplantation for malignant blood diseases: a survey of the European Group for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 35, 121–124 (2005). https://doi.org/10.1038/sj.bmt.1704727

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