Treatment of malignant glioma with high dose intra-arterial ACNU and autologous bone marrow transplantation--case report.
A 44-year-old female with malignant astrocytoma received subtotal removal and high dose (200 mg/m2) intra-arterial 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2- chloroethyl)-3-nitrosourea hydrochloride (ACNU) with autologous bone marrow transplantation. Tumor remission with minimal bone marrow suppression was achieved. However, she developed severe encephalopathy and computed tomographic scans revealed a low-density area at the ACNU delivery site. She received glycerol solution to treat the brain edema and recovered completely from the encephalopathy. Intra-arterial ACNU exceeding 200 mg/m2 possibly causes neurotoxicity.
Fujiwara
T
T
Department of Neurological Surgery, Kagawa Medical School.
Yoshioka
J
J
Ohmoto
T
T
D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced / Q000601:surgery; D001254:Astrocytoma / Q000188:drug therapy* / Q000601:surgery; D016026:Bone Marrow Transplantation; D001929:Brain Edema / Q000139:chemically induced / Q000188:drug therapy; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000601:surgery; D005990:Glycerol / Q000627:therapeutic use; D006801:Humans; D007269:Injections, Intra-Arterial; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy; D015376:Nimustine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000139:chemically induced / Q000601:surgery
D015376:Nimustine; D005990:Glycerol