Journal of neuro-oncology
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Journal of neuro-oncology · Nov 2009
Case ReportsNeurolymphomatosis: a rare metastatic complication of diffuse large B-Cell lymphoma.
To report the occurrence of neurolymphomatosis in a patient with previously treated systemic diffuse B-cell lymphoma (DLBCL). A case report. University medical center. ⋯ High-dose methotrexate and involved-field radiotherapy. Neurolymphomatosis, although rare, is increasingly recognized with peripheral and central nervous system MRI. Treatment remains unsatisfactory as treatment with methotrexate-based chemotherapy and irradiation is only partially effective.
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Journal of neuro-oncology · Nov 2009
Non-PEGylated liposomes for convection-enhanced delivery of topotecan and gadodiamide in malignant glioma: initial experience.
Convection-enhanced delivery (CED) of highly stable PEGylated liposomes encapsulating chemotherapeutic drugs has previously been effective against malignant glioma xenografts. We have developed a novel, convectable non-PEGylated liposomal formulation that can be used to encapsulate both the topoisomerase I inhibitor topotecan (topoCED) and paramagnetic gadodiamide (gadoCED), providing an ideal basis for real-time monitoring of drug distribution. Tissue retention of topoCED following single CED administration was significantly improved relative to free topotecan. ⋯ In a U87MG intracranial rat xenograft model, a two-dose CED regimen of topoCED co-infused with gadoCED greatly increased median overall survival at dose levels of 0.5 mg/ml (29.5 days) and 1.0 mg/ml (33.0 days) vs. control (20.0 days; P < 0.0001 for both comparisons). TopoCED at higher concentrations (1.6 mg/ml) co-infused with gadoCED showed no evidence of histopathological changes attributable to either agent. The positive results of tissue pharmacokinetics, co-convection, cytotoxicity, efficacy, and lack of toxicity of topoCED in a clinically meaningful dose range, combined with an ideal matched-liposome paramagnetic agent, gadoCED, implicates further clinical applications of this therapy in the treatment of malignant glioma.