The frequency of administration varied from once a day for 4 days to once every 4 days. The dosage schedule is usually governed by the type and severity of central nervous system manifestations and the response to previous therapy. If used intrathecally, do not use a diluent containing benzyl alcohol. Cytarabine given intrathecally may cause systemic toxicity and careful monitoring of the hemopoietic system is indicated. Modification of other anti leukemia therapy may be necessary.
Major toxicity is rare.
Paraplegia has been reported. 30 Isolated neurotoxicity has been reported. 31 Blindness occurred in two patients in remission whose treatment had consisted of combination systemic chemotherapy, prophylactic central nervous system radiation and intrathecal cytarabine. When cytarabine is administered both intrathecally and intravenously within a few days, there is an increased risk of spinal cord toxicity. However, in serious life-threatening disease, concurrent use of intravenous and intrathecal cytarabine is left to the discretion of the treating physician.