Neurotoxicity of intraventricularly administered alpha-interferon for leptomeningeal disease.
Nine patients with leptomeningeal disease are reported who were treated with intraventricular alpha-interferon (alpha-IFN). In seven of these patients, a progressive vegetative state developed during treatment. The patients became unresponsive to verbal commands but opened their eyes with auditory or tactile stimulation. It took an average of 3 weeks for these patients to become verbally responsive after treatment was discontinued. Electroencephalographic findings showed evidence of irritative involvement of the deep midline nuclei in 80% of patients. Periventricular white matter changes developed during treatment in three of six patients who underwent computed tomographic scans. All patients with this severe neurotoxicity received whole-brain irradiation before treatment. Possible mechanisms for the development of this neurotoxic syndrome are discussed. The neurotoxicity of alpha-IFN and brain irradiation may be additive, suggesting a cautious approach when using this combination for treatment.
Meyers
C A
CA
Department of Neuro-Oncology, M.D. Anderson Cancer Center, Houston, TX 77030.
Obbens
E A
EA
Scheibel
R S
RS
Moser
R P
RP
D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology; D003128:Coma / Q000175:diagnosis / Q000209:etiology*; D004341:Drug Evaluation; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects*; D008175:Lung Neoplasms / Q000473:pathology; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000556:secondary; D008577:Meningeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary; D008875:Middle Aged; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D007370:Interferon Type I