title: Bone marrow metastasis in astrocytic gliomata.
abstract: With the increasing survival time of many pediatric patients with malignancies, unexpected symptoms or signs require diligent search for rare complications or second cancers related to the disease or treatment. We recently encountered a patient with extensive glioblastoma multiforme who developed pancytopenia six months after completion of treatment with craniospinal radiation and chemotherapy with etoposide and cyclophosphamide. Bone marrow aspirate and biopsy confirmed bone marrow metastasis from the brain tumor. He showed good partial remission with chemotherapy with carmustine and cis-platinum as demonstrated by serial bone marrow aspirate for cytology and cytogenetics and enjoyed good quality of life for eight months. 14 other patients with astrocytic glioma, two of whom are children, are reported in the literature to have diffuse bone marrow metastasis. Therefore, in patients with malignant astrocytic tumor, bone marrow metastasis, though not common, should be considered when bone pain or cytopenias occur, especially when prolonged.
authors.affiliation: Pediatric Neuro-oncology Service, Children's Hospital of Eastern Ontario, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Hsu
authors.forename: D
authors.initials: D
authors.lastname: Keene
authors.forename: E
authors.initials: E
authors.lastname: Ventureyra
authors.forename: M A
authors.initials: MA
authors.lastname: Matzinger
authors.forename: C
authors.initials: C
authors.lastname: Jimenez
authors.forename: H S
authors.initials: HS
authors.lastname: Wang
authors.forename: L
authors.initials: L
authors.lastname: Grimard
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001254:Astrocytoma / Q000188:drug therapy / Q000556:secondary*; D019046:Bone Marrow Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology; D002330:Carmustine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
chemical_list: D002945:Cisplatin; D002330:Carmustine