Cerebral ventricular fluid distribution of subcutaneous granulocyte-macrophage colony stimulating factor.
After treating a child suffering from disseminated primitive neuroectodermal tumor and hydrocephalus with bilateral ventriculostomies, we administered intravenous high dose thiotepa followed by a single subcutaneous dose of GM-CSF 24 hours later. The appearance and clearance of GM-CSF were measured from both ventricles, one of which was surrounded by tumor. Peak levels of GM-CSF were recorded simultaneously in both ventricles 11 hours after injection. Complete clearance from injection required 15 hours and 31 hours for the tumor-free right ventricle and the tumor-involved left ventricular wall, respectively. Tumor response was ephemeral and limited to ventricular fluid WBC, protein and LDH decreases. Microglia were detected; however, there was no evidence of anti-tumor activity in biopsied tumor tissue. Tumored regions of the brain may have perturbation of GM-CSF distribution and clearance which may contribute to the lack of microglial activity.
Helson
L
L
Department of Medicine, New York Medical College, Valhalla 10595.
Braverman
S
S
Rifkinson
S
S
Helson
C
C
D001932:Brain Neoplasms / Q000188:drug therapy; D002648:Child; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D006801:Humans; D006849:Hydrocephalus; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D018242:Neuroectodermal Tumors, Primitive / Q000188:drug therapy; D013852:Thiotepa / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics
D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D013852:Thiotepa