Skip to main content
Log in

Intensive chemotherapy with autologous bone marrow rescue for recurrent malignant gliomas

  • Chemotherapy and immunotherapy of malignant gliomas
  • —A contribution by Japanese Neurosurgery—
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Summary

Eight patients, four male and four female, were treated with high dose chemotherapy followed by bone marrow transplantation. In the first two patients, high dose ACNU was used for the treatment without combination with other drugs. This showed severe side effects such as intratumorous bleeding on the 18th day of treatment in the first case and pulmonary fibrosis on the 35th day of treatment in the second case. Considering these results, we considered another treatment schedule which consisted of high dose ADM (100 mg/m2), VCR (1.5 mg/m2), CDDP (80 mg/m2 × 4) and Ex (800 mg/m2) within seven days.

Six patients were treated with this schedule and the results indicated that two patients had a partial response (more than 50% reduction of tumour size measured by CT scan), one had a complete remission (no tumour detected by CT scan), two showed no change and one, progression of the lesion.

The patients recovered from the suppression of bone marrow function after the bone marrow transplantation as indicated. Granulocytes and platelets in blood began to increase from 10 to 14 days after the transplantation and became normal within three weeks after this.

Serial measurements of S-GOT and alkaline phosphatase revealed reversible elevation, if any, within four weeks of the treatment.

The number of our cases is still small, but results showed that autologous bone marrow transplantation made high dose chemotherapy possible.

The necessity for consideration of the blood-brain barrier for this treatment is also discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Burger, P. C., E. Kamenar, S. C. Schold: Encephalomyelopathy following high-dose BCNU therapy. Cancer 48 (1981) 1318–1327

    Google Scholar 

  2. Cooperative study group of phase 1. study on ACNU: Phase 1 study of 1-(4-amino-2-methyl-5-pyrimidyl)-methyl-3-(2-chlorethyl)-3-nitrosourea hydrochloride (ACNU). Jap. J. Clin. Oncol. 6 (1976) 55–62.

    Google Scholar 

  3. Durant J. R., M. J. Norgard, T. M. Murad: Pulmonary toxicity associated with bis-chloroethyl-nitrosourea (BCNU). Ann. Intern. Med. 90 (1979) 191–194

    Google Scholar 

  4. Hochberg, F. H., L. M. Parker, T. Takvorian: Highdose BCNU with autologous bone marrow rescue for recurrent glioblastoma multiforme. J. Neurosurg. 54 (1981) 455–460

    Google Scholar 

  5. Levin, V. A., M. Freedman-Dove, H. D. Landahl: Permeability characteristics of brain adjacent to tumours in rats. Arch. Neurol. 32 (1975) 785–791

    Google Scholar 

  6. Levin, V. A., C. B. Wilson, R. Davis: A phase III study comparison of BCNU, hydroxyurea and radiation therapy for treatment of primary malignant gliomas. J. Neurosurg. 51 (1979) 526–532

    Google Scholar 

  7. Masuda, H., K. Kimura, T. Okada: Toxicological studies of CS-439 (ACNU). Ann. Rep. Sankyo Res. Lab. 29 (1977) 118–137

    Google Scholar 

  8. Rall, D. D., C. G. Zubrod: Mechanism of drug absorption and excretion. Passage of drugs in and out of the central nervous system. Ann. Rev. Pharmacol. 2 (1962) 109–128

    Google Scholar 

  9. Saito, Y., Y. Nakaya, K. Muraoka: Chemotherapy of brain tumours with nitrosourea derivatives (ACNU). Gan to Kagakuryoho 5 (1978) 779–794

    Google Scholar 

  10. Schabel, M. F., D. J. Johnston, S. G. McCaleb: Experimental evaluation of potential anticancer agents, VIII: Effect of certain nitrosourea on intracerebral L1210 leukemia. Cancer Res. 23 (1963) 725–733

    Google Scholar 

  11. Schacht, R. G., D. S. Baldwin: Chronic interstitial nephritis and renal failure due to nitrosourea (NU) therapy. Kidney Int. 14 (1978) 661 (abstract)

    Google Scholar 

  12. Shapiro, W. R., J. L. Ausman, D. P. Rall: Studies on the chemotherapy of experimental brain tumors: evaluation of 1,3-bis (2-chlorethyl)-1-nitrosourea, cyclophosphamide, mithramycin and methotrexate. Cancer Res. 30 (1970) 2401–2413

    Google Scholar 

  13. Shibui, S., T. Watanabe, Y. Miki: High dose chemotherapy with autologous bone marrow transplantation for malignant brain tumours. Neurological surgery 11 (1983) 723–729

    Google Scholar 

  14. Shimoyama, M.: The cytocidal action of alkylating agents and anticancer antibiotics againstin vitro cultured Yoshida ascites sarcoma cells. J. Jpn. Soc. Cancer Ther. 10 (1975) 63–72

    Google Scholar 

  15. Spitzer, G., K. A. Dicke, S. Verma: High-dose BCNU therapy with autologous bone marrow infusion: Preliminary observations. Cancer Treat Rep. 63 (1979) 1257–1264

    Google Scholar 

  16. Thomas, E. D., R. Storb: Technique for human marrow grafting. Blood 36 (1970) 507–515

    Google Scholar 

  17. Thompson, G. R., R. E. Larson: A toxicologic comparison of the potency and activity of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) in mice and rats1−3. Toxicol. Appl. Pharmacol. 21 (1972) 405–413

    Google Scholar 

  18. Weiner, R. S., J. A. Tobias, R. A. Yankee: The processing of human bone marrow for cryopreservation and reinfusion. Biomedicine 24 (1976) 226–231

    Google Scholar 

  19. Wasserman, T. H., M. Slavik, S. K. Carter: Clinical comparison of the nitrosoureas. Cancer 36 (1975) 1256–1268

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nomura, K., Watanabe, T., Nakamura, O. et al. Intensive chemotherapy with autologous bone marrow rescue for recurrent malignant gliomas. Neurosurg. Rev. 7, 13–22 (1984). https://doi.org/10.1007/BF01743286

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01743286

Keywords

Navigation