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Liposomal cytarabine is a sustained-release formulation of the antimetabolite cytarabine, encapsulated within multivesicular liposomes using DepoFoam technology. It is specifically designed for intrathecal administration to treat neoplastic meningitis, particularly lymphomatous meningitis. Cytarabine, a pyrimidine analog, is converted intracellularly into cytarabine triphosphate, which competes with deoxycytidine triphosphate for incorporation into DNA and inhibits DNA polymerase, leading to S-phase specific cell cycle arrest and apoptosis. The liposomal delivery system significantly extends the half-life of the drug in the cerebrospinal fluid (CSF) from hours to several days, allowing for extended drug exposure and reducing the frequency of required lumbar punctures. In the REBOOT ABLY (Reduced Burden of Oncologic Therapy in Advanced B-Cell Lymphoma) trial led by New York Medical College, it is being investigated as part of a modified regimen to reduce the treatment burden and long-term complications in children, adolescents, and young adults with mature B-cell non-Hodgkin lymphoma, including Burkitt lymphoma and diffuse large B-cell lymphoma.
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