Successful treatment of primary central nervous system lymphomas with chemotherapy after osmotic blood-brain barrier opening

E. A. Neuwelt, Edward Balaban, J. Diehl, S. Hill, E. Frenkel

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Three patients with primary central nervous system (CNS) lymphoma have had major tumor regression with multiagent chemotherapy given in association with reversible blood-brain barrier opening used to enhance drug delivery to the tumor. In addition, in one patient barrier modification was carried out in the posterior fossa by mannitol infusion into the vertebral artery without untoward effects, an approach not heretofore accomplished. Computed tomographic (CT) studies documented that discontinuation of steroids rapidly effected an increase in the delivery of contrast agent to the tumor. CT monitoring of the degree of barrier modification showed tumor nodules and tumor size not apparent on the control scans, thereby providing additional evidence of the existence of a blood-brain barrier in CNS tumors. These studies further show that drug (contrast) delivery to the tumor, as well as to the surrounding barrier, is enhanced after reversible blood-brain barrier modification. Finally, chemotherapy administered by this approach resulted in defined, objective tumor responses in these three patients.

Original languageEnglish (US)
Pages (from-to)662-671
Number of pages10
JournalUnknown Journal
Volume12
Issue number6
DOIs
StatePublished - Jan 1 1983

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Blood-Brain Barrier
Lymphoma
Central Nervous System
Drug Therapy
Neoplasms
Therapeutics
Central Nervous System Neoplasms
Vertebral Artery
Mannitol
Pharmaceutical Preparations
Contrast Media
Steroids

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

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Successful treatment of primary central nervous system lymphomas with chemotherapy after osmotic blood-brain barrier opening. / Neuwelt, E. A.; Balaban, Edward; Diehl, J.; Hill, S.; Frenkel, E.

In: Unknown Journal, Vol. 12, No. 6, 01.01.1983, p. 662-671.

Research output: Contribution to journalArticle

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AB - Three patients with primary central nervous system (CNS) lymphoma have had major tumor regression with multiagent chemotherapy given in association with reversible blood-brain barrier opening used to enhance drug delivery to the tumor. In addition, in one patient barrier modification was carried out in the posterior fossa by mannitol infusion into the vertebral artery without untoward effects, an approach not heretofore accomplished. Computed tomographic (CT) studies documented that discontinuation of steroids rapidly effected an increase in the delivery of contrast agent to the tumor. CT monitoring of the degree of barrier modification showed tumor nodules and tumor size not apparent on the control scans, thereby providing additional evidence of the existence of a blood-brain barrier in CNS tumors. These studies further show that drug (contrast) delivery to the tumor, as well as to the surrounding barrier, is enhanced after reversible blood-brain barrier modification. Finally, chemotherapy administered by this approach resulted in defined, objective tumor responses in these three patients.

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