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What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.


Treats leukemia… Read more

Oral route

Cytarabine belongs to the group of medicines called antimetabolites. It is used to treat some kinds of cancers of the blood. It may also be used to treat… Read more

Drug classes About this
Antimetabolite, Antineoplastic Agent

What works? Research summarized

Evidence reviews

Interferon alfa versus interferon alfa plus cytarabine combination therapy for chronic myeloid leukemia: a meta-analysis of randomized controlled trials

The review concluded that compared with interferon alpha alone, combined interferon alpha plus cytarabine significantly improved complete haematologic response and cytogenic response rates and improved three-year and five-year survival, but was more likely to cause serious adverse events. The reviewers? conclusions should be considered tentative due to potential for bias and the poor quality evidence base.

Meta-analysis of randomised clinical trials comparing idarubicin + cytarabine with daunorubicin + cytarabine as the induction chemotherapy in patients with newly diagnosed acute myeloid leukaemia

BACKGROUND: To determine whether the use of idarubicin+cytarabine (IA) is more effective than the use of daunorubicin+cytarabine (DA) as induction chemotherapy for patients with newly diagnosed acute myeloid leukaemia.

Dasatinib and Nilotinib for Imatinib-Resistant or -Intolerant Chronic Myeloid Leukaemia: A Systematic Review and Economic Evaluation

Chronic myeloid leukaemia (CML) is a form of cancer affecting the blood, characterised by excessive proliferation of white blood cells in the bone marrow and circulating blood. In the UK, an estimated 560 new cases of CML are diagnosed each year.

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Summaries for consumers

The role of chemotherapy additional to high‐dose methotrexate for treatment of patients with primary central nervous system lymphoma

Primary central nervous system lymphoma (PCNSL) is a malignant disease of the lymphatic system that accounts for about 2% to 5% of all primary intracranial tumours in immunocompetent patients. It is a form of extranodal non‐Hodgkin lymphoma (NHL) and appears at a median age of 62 years. PCNSL is a rare disease with an incidence of 2.7 cases per million population per year, but since the 1990s the occurrence of it has increased in immunocompetent as well as immunocompromised (mostly human immunodeficiency virus (HIV)‐infection related) populations. Symptoms of PCNSL can present manifold though the usual signs are neurological deficits, neuropsychiatric symptoms and raised intracranial pressure. Despite improved treatment strategies, overall survival is still poor and a standard of care for PCNSL patients has not been defined yet. However, high‐dose methotrexate (HD‐MTX) with additional chemotherapy is considered to increase overall survival although the value of additional chemotherapy remains unclear, as there is evidence of a higher risk of adverse events. In this systematic review we summarised and analysed the evidence from randomised controlled trials (RCTs) on efficacy and safety of methotrexate combined with additional chemotherapy in the treatment of adult, immunocompetent PCNSL patients regarding overall survival, progression‐free survival, response rate, adverse events, treatment‐related mortality and quality of life. We searched several important medical databases such as CENTRAL and MEDLINE and found one RCT with 79 patients that fulfilled our inclusion criteria. As a result, this review shows that patients treated with methotrexate plus cytarabine compared to high‐dose methotrexate alone have a statistically significant improvement in progression‐free survival and response rate. No statistically significant difference is shown for overall survival. Adverse events, especially infections, hepatotoxicity and haematological toxicities are more common in patients undergoing therapy with methotrexate plus cytarabine, although there are no differences in terms of treatment‐related mortality. Owing to the small number of included trials and patients, the findings in this review remain uncertain and more RCTs with enlarged numbers of patients and longer follow‐up periods are needed. However, the one analysed study demonstrated that RCTs are feasible on patients with this rare disease and should concentrate on overall survival.

The role of brain radiotherapy (X‐rays) in the treatment of lymphoma in the brain

Background: Primary central nervous system lymphoma (PCNSL) is a type of cancer that occurs in the brain or spinal cord. It is a rare and aggressive type of lymphoma. People who develop PCNSL survive for only four months on average, if they do not receive treatment. For a long time the only treatment showing any benefit was whole brain radiotherapy (WBR), in which X‐rays are used to destroy cancerous cells in the brain. However, several studies suggest that this treatment method also produces signs of damage to healthy brain tissue. Since the introduction of methotrexate, a powerful chemotherapy drug showing great beneficial effects, experts have debated the role of radiotherapy in the treatment of people with PCNSL. Radiotherapy could be combined with chemotherapy, or not used at all, especially considering its potentially harmful effects.

High‐dose chemotherapy followed by autologous stem cell transplantation for patients with relapsed/refractory Hodgkin lymphoma

Hodgkin lymphoma (HL) is a malignancy of single lymph nodes, the lymphatic system, and might affect other additional organs. It is a relatively rare disease, accounting for two or three people per 100,000 every year in Western countries, but it is one of the most common cancers in young adults between 20 and 30 years of age. The second peak of the disease is after the age of 60 years. Treatment options for HL have improved since the 1980s, so that even patients in advanced stages may be cured with adequate therapy. Treatment approaches include chemotherapy, radiotherapy or chemotherapy combined with radiotherapy (combined‐modality treatment), of which the combined‐modality treatment is standard for most patients nowadays. Nevertheless, 15% to 20% of patients do not reach complete remission and have refractory disease or relapse. For these patients high‐dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) has become the optimal treatment option. However, the impact of this regimen on overall survival is still unclear. Therefore, we conducted a Cochrane Review on efficacy and safety of HDCT followed by ASCT in patients with primary refractory or relapsed HL. We searched several important medical databases (the Cochrane Central Register of Controlled Trials and MEDLINE) and summarised and analysed evidence from randomised controlled trials (RCTs). We identified three RCTs corresponding to our pre‐defined inclusion criteria treating 398 patients. We included two trials that compared HDCT followed by ASCT versus conventional chemotherapy alone, and one trial evaluating additional sequential HDCT (SHDCT) followed by ASCT against HDCT followed by ASCT.

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