Numerous queries continue to be, like the optimum combination of agents as well as the importance of intra CSF chemotherapy. Forty eight consecu tive patients with newly diagnosed, histologically or cytologically confirmed PCNSL had been handled with intravenous MTX on days 1, 14, 28, 42, and then regular monthly for one 12 months. Rituximab was administered with MTX for the to start with six months. At one particular in the three participating institutions, all evaluable individuals also acquired ten doses of intraventricular DepoCyt at the time of MTX treatment method. The individuals have been followed up clinically and radiographi cally. Individuals ranged in age from 18 93 years with 21 patients 60 many years, and also the overall KPS was 50 a hundred. Tumors were multifocal in 41% of individuals. selleck Lym phomatous meningitis was documented prior to treatment in 42% of all sufferers but in 78% of individuals from whom large ventricu lar CSF samples had been obtained.
Diagnosis was established by biopsy in 38 sufferers, resection in eight individuals, and various suggests in three patients. In 267 treatment cycles, toxicity grade III occurred in 11 cycles and incorporated anemia, neutropenia, thrombocytopenia, nephrotoxicity, and mucositis. From the 48 evaluable patients, 31 had a comprehensive initial response to remedy, twelve had a partial additional reading response, one secure sickness, and 4 progressive ailment. Soon after a median of 19 months of comply with up, median survival hasn’t been reached. One particular and 2 12 months survival rates for all 48 individuals are 83% and 64%, respec tively, and didn’t vary amongst patients who received or did not obtain intrathecal chemotherapy. The median time to progression was 12 months, Time for you to progression was longer in patients handled at diagnosis with intrathecal DepoCyt than in sufferers not taken care of intrathecally. In a multivariate analysis, good CSF cytology and multifocal tumor pre dicted worse outcomes but did not attain statistical significance.
This regi guys is helpful and effectively tolerated in patients with PCNSL. CSF involvement at diagnosis appears additional common than previously demonstrated but docu mentation might need many large volume ventricular CSF sampling. A optimistic CSF cytology

and multifocal tumor may perhaps represent poor prognositic signs. Intra CSF chemotherapy at diagnosis appears to delay time for you to recur rence, but a survival benefit hasn’t been demonstrated. TA 17. SECONDARY ACUTE MYELOGENOUS LEUKEMIA IN THREE Patients Taken care of WITH TEMOZOLOMIDE FOR GLIAL NEOPLASM A. Fitzsimmons, T. Batchelor, A. ONeill, and J. Henson, Massachusetts General Hospital, Boston, MA, USA Temozolomide, an oral alkylating agent and very first line therapy for glioblastoma, is being increasingly used, often over protracted periods of time, in patients with low grade and anaplastic gliomas These tumors are often associated with prolonged survival.