The Potential of Liquorpheresis to Treat Leptomeningeal Disease

Victor M Lu; Ashish H Shah; Manuel Menéndez González

doi:10.1016/j.wneu.2024.04.049

The Potential of Liquorpheresis to Treat Leptomeningeal Disease

World Neurosurg. 2024 Apr 16:187:93-98. doi: 10.1016/j.wneu.2024.04.049. Online ahead of print.

Authors

Victor M Lu¹, Ashish H Shah², Manuel Menéndez González³

Affiliations

¹ Department of Neurological Surgery, University of Miami, Miami, Florida, USA. Electronic address: victor.lu@jhsmiami.org.
² Department of Neurological Surgery, University of Miami, Miami, Florida, USA.
³ Department of Medicine, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.

PMID: 38636632
DOI: 10.1016/j.wneu.2024.04.049

Abstract

Leptomeningeal disease (LMD) is a devastating sequela of many cancers, with an extremely poor prognosis. Barriers to improving outcomes are related to the inability of many traditional therapies to effectively reach the cerebrospinal fluid (CSF) space within the central nervous system. Liquorpheresis is an emerging treatment modality specific to CSF diseases, the primary mechanism of action of which is direct targeted filtration of CSF content by neurosurgical access. In this review, we highlight the principles of liquorpheresis and detail how LMD can be amenable to this treatment. Further, we summarize the current in vitro and in vivo evidence supporting liquorpheresis as a feasible method to treat LMD and other central nervous system diseases as well as describe its conceivable limitations.

Keywords: CSF; Cerebrospinal fluid; Filtration; LMD; Leptomeningeal disease; Liquorpheresis.

Publication types

Review