Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
A pilot study of chemotherapy (CTx) of non-Hodgkin's lymphoma arising in the CNS or eye (Meeting abstract).
Proc Annu Meet Am Soc Clin Oncol; 13:A510 1994. Unique Identifier : AIDSLINE ICDB/94600506 Stark-Vancs V; Setser A; Kohler D; Heiss J; Martin D; Nussenblatt R; Whitcup S; deSmet M; Jaffe E; Patronas N; et al; NIH, Bethesda, MD 20892
Abstract:
Eight minimally pretreated patients (pts) with primary CNS lymphoma or CNS metastases from ocular lymphoma (all HIV-) were treated on a pilot study to evaluate the feasibility of a regimen using high-dose methotrexate (MTX) with leucovorin rescue (LCV; Cancer Treat Rev 4:87, 1977), thiotepa (TPA), vincristine (VCR), intraventricular cytarabine (ara-C), and dexamethasone (DX). Results are presented in a table. Cycles were repeated q 21 days to 2 cycles after complete response (CR) or stable partial response (PR) x2 cycles. Prior therapy included radiation therapy (RT), 2 pts; ara-C, 1 pt; combination CTx, 0 pts. Two pts had evidence of ocular lymphoma by funduscopic exam; 5 had positive CSF cytology. MTX levels [MTX] were obtained q 6 hr during the infusion and q 12-24 hr, thereafter. During the MTX infusion, the mean serum [MTX] was 1.56 x 10(4) M and mean CSF [MTX] was 1.86 x 10(6) M. LCV was continued until the serum [MTX] was less than or equal to 5.0 x 10(8) M, for a mean of 6.1 days post-MTX. Of 33 evaluable cycles, 1 was complicated by grade (G) 4 ileus; 3 by G 4 neurotoxicity (seizures) in 2 pts; 2 pts had G 2 renal toxicity which resolved. Two pts who had prolonged G 3 or 4 neutropenia received G-CSF with subsequent cycles. Of 7 pts currently evaluable for response, there were 5 CRs and 2 PRs and 1 too early to evaluate. One pt who was removed from study for toxicity (ileus) was evaluable for response (CR). One pt achieved a CR, but relapsed within 1 mo after completion of all therapy (6 cycles); he received RT and CTx and is alive with disease. Both pts with ocular lymphoma achieved CR by funduscopic exam within 3 cycles. The presence of cytokines in the serum and CSF and presence of Epstein-Barr virus in tumor specimens currently are being analyzed for all pts. The role of magnetic resonance spectroscopy in the evaluation of CNS lymphoma is also being investigated. This regimen achieves a high initial response rate in CNS and ocular lymphoma and was generally well tolerated.
Keywords: Antineoplastic Agents, Combined/ADVERSE EFFECTS/*THERAPEUTIC USE Brain Neoplasms/*DRUG THERAPY/SECONDARY Dose-Response Relationship, Drug Drug Administration Schedule Eye Neoplasms/*DRUG THERAPY Feasibility Studies Human Lymphoma, Non-Hodgkin's/*DRUG THERAPY Pilot Projects ABSTRACT 941030
M94A0891
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
