scholarly journals Improved Neurodevelopmental Outcomes following Long-Term High-Dose Oral Acyclovir Therapy in Infants with Central Nervous System and Disseminated Herpes Simplex Disease

2004 ◽  
Vol 25 (3) ◽  
pp. 156-161 ◽  
Author(s):  
K F Tiffany ◽  
D K Benjamin ◽  
P Palasanthiran ◽  
K O'Donnell ◽  
L T Gutman
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Herpes Simplex ◽  
High Dose ◽  
Oral Acyclovir ◽  
Neurodevelopmental Outcomes ◽  
Dose Oral ◽  
Acyclovir Therapy

CNS Stimulant Controversies

1989 ◽  
Vol 23 (4) ◽  
pp. 497-502 ◽  
Author(s):  
Florence Levy
Keyword(s):  
Central Nervous System ◽  
Animal Model ◽  
Nervous System ◽  
High Dose ◽  
Ethical Considerations ◽  
Hyperactivity Disorder ◽  
Central Nervous System Stimulant ◽  
Stimulant Medications ◽  
Cns Stimulant

Controversies in the use of central nervous system stimulant medications in children with attention deficit hyperactivity disorder are discussed. Diagnostic issues, age of optimal use, side effects, effects on learning and ethical considerations are current issues. An animal model for the effects of chronic long-term high dose regimes is proposed.

Primary Central Nervous System Lymphoma in Children: A Report of 12 Cases.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3300-3300
Author(s):  
Oussama Abla ◽  
John T. Sandlund ◽  
Susan Blaser ◽  
Penelope Brock ◽  
Rob Corbett ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Lymphoma ◽  
Large Cell ◽  
The Other ◽  
High Dose ◽  
Radiation Toxicity ◽  
Congenital Immunodeficiency ◽  
Hodgkin's Lymphomas

Abstract We report the treatment and outcome of 12 children with primary central nervous system lymphoma (PCNSL) treated at 6 pediatric oncology centers from 1995 to 2003. The main purpose is to determine whether childhood PCNSL can be cured with chemotherapy alone without cranial radiation therapy (CRT). The clinical charts of 8 immunocompetent and 4 immunodeficient children with PCNSL were retrospectively reviewed. The children were diagnosed from 4 to 17 years of age. All cases were non-Hodgkin’s lymphomas: 7 (58.3%) were phenotypically B-cell (6 mature B, one B-precursor), 3 (25%) were T-cell and 2 (16.6%) were indeterminate-cell type. The histologic subtyping (REAL classification) showed 4 diffuse large cell, 4 anaplastic large cell, 2 immunoblastic large cell, 1 Burkitts and 1 high-grade lymphoma of uncertain lineage. Two patients were t(2;5) positive. Two patients had congenital immunodeficiency and 2 were HIV+. Immunologic work-up was either normal or not done in the remaining 8. EBV was positive in 2 patients, negative in 3 and not assessed in the rest. PCNSL presented as a single lesion in 4 patients and multifocal in 8. The most frequent tumor locations were frontal and parietal lobes. Nine of 12 children received chemotherapy alone, event free survival (EFS) at 4 years was 74±16%. Three had chemo plus CRT (3900–5000 cGy), EFS was 33±27% (P=0.1). The most frequently used drugs at the 6 centers were high dose (HD) MTX (5 to 8 g/m2), HD Ara-C (2 to 3 g/m2), dexamethasone, vincristine and cyclophosphamide. Three children died, 2 of whom were HIV+; 1 died after local relapse while the other died secondary to an opportunistic infection. Two other patients relapsed, one after chemotherapy alone and one after chemotherapy plus CRT. The patient who relapsed after chemotherapy alone is in second CR at 6+ months after chemotherapy, CRT and ABMT; the other patient died from progressive disease. Nine of 12 patients (75%) are alive at a median follow-up time of 72 months (range 18–105 months) in survivors. Six of the 8 children who are in CCR received chemotherapy alone, one received chemotherapy plus ABMT and one received chemotherapy plus CRT. Two of the long-term survivors (in CCR at 88+ and 105+ mo) had congenital immunodeficiency and were treated with chemotherapy alone. It appears that immunocompetent and immunodeficient children with PCNSL may be cured with chemotherapy alone without CRT, avoiding long-term radiation toxicity. Although retrospective, involving a small cohort, it is the largest pediatric series of PCNSL reported to date. Multicentre prospective studies are clearly needed in children with this rare lymphoma, whose frequency seems to be increasing especially in immunocompetent patients.

scholarly journals First-line high-dose therapy and autologous blood stem cell transplantation in patients with primary central nervous system non-Hodgkin lymphomas—a single-centre experience in 61 patients

2022 ◽  
Author(s):  
T. Brezina ◽  
H. von Dewitz ◽  
T. Schroeder ◽  
S. Ullrich ◽  
K. Nachtkamp ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Autologous Blood ◽  
High Dose ◽  
First Line ◽  
High Dose Therapy ◽  
Blood Stem Cell Transplantation

AbstractPrimary central nervous system non-Hodgkin lymphomas (PCNS-NHLs) are extranodal B-cell lymphomas with poor prognosis. The role of high-dose therapy (HDT) followed by autologous blood stem cell transplantation (ASCT) as first-line therapy is still not clear. We retrospectively collected long-term follow up data of 61 consecutive patients with PCNS-NHL at the University Hospital Düsseldorf from January 2004 to December 2016. Thirty-six patients were treated with conventional chemoimmunotherapy (cCIT) only (CT-group). Seventeen patients received an induction cCIT followed by HDT and ASCT. In the CT-group, the overall response rate (ORR) was 61% (CR 47%, PR 14%), and there were 8% treatment-related deaths (TRD). Progression-free survival (PFS) was 31.8 months, and overall survival (OS) was 57.3 months. In the HDT-group, the ORR was 88% (59% CR, 29% PR), and there were 6% TRD. Median PFS and OS were not reached at 5 years. The 5-year PFS and OS were 64.7%. After a median follow up of 71 months, 10 patients (59%) were still alive in CR/PR following HDT and ASCT, one patient was treated for progressive disease (PD), and 7 had died (41%, 6 PD, 1 TRD). All patients achieving CR prior to HDT achieved durable CR. In the CT-group, 8 patients (22%) were alive in CR/PR after a median follow-up of 100 months. Twenty-eight patients died (78%, 24 PD, 2 TRD, 2 deaths in remission). In the univariate analysis, the HDT-group patients had significantly better PFS (not reached vs 31.8 months, p = 0.004) and OS (not reached vs 57.3 months, p = 0.021). The multivariate analysis showed HDT was not predictive for survival. Treatment with HDT + ASCT is feasible and offers the chance for long-term survival with low treatment-related mortality in younger patients. In this analysis, ORR, PFS and OS were better with HDT than with conventional cCIT alone. This result was not confirmed in the multivariate analysis, and further studies need to be done to examine the role of HDT in PCNSL.

scholarly journals EBV-positive central nervous system lymphoproliferative disease associated with immunosuppression after organ transplantation: Long-term remission without chemotherapy

2017 ◽  
Vol 89 (7) ◽  
pp. 69-75 ◽  
Author(s):  
O A Gavrilina ◽  
V V Troitskaya ◽  
E E Zvonkov ◽  
E N Parovichnikova ◽  
G M Galstyan ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Immunosuppressive Therapy ◽  
B Cell Lymphoma ◽  
Lymphoproliferative Disease ◽  
High Dose ◽  
Barr Virus ◽  
Epstein Barr ◽  
Cns Lymphomas

Primary central nervous system (CNS) lymphomas account for 13-20% of the posttransplant lymphoproliferative disorders (PTLD) and rank among the most aggressive conditions. Reduction of immunosuppressive therapy should be mandatory to treat PTLD, but this is rarely used as the only therapy option. Chemotherapy regimens for PTLD involving the CNS most commonly include high-dose rituximab and high-dose methotrexate and/or cytarabine. The efficiency only of discontinuation of immunosuppressive therapy for PTLD does not exceed 5—10%, but there are no literature data on its efficiency for PTLD involving the CNS. The paper describes a clinical case of achieving long-term remission in a female patient with Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma involving the central nervous system, associated with immunosuppression after kidney transplantation from a related donor, in the absence of chemotherapy during immunosuppressive therapy discontinuation and transplantectomy.

An Update on Therapy of Primary Central Nervous System Lymphoma

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 311-316 ◽  
Author(s):  
Lisa M. DeAngelis ◽  
Fabio M. Iwamoto
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Lymphoma ◽  
Cns Lymphoma ◽  
High Dose ◽  
Lymphoma Treatment ◽  
Neurologic Sequelae ◽  
Radiotherapy Alone ◽  
Convincing Data

AbstractThe most important advance in primary central nervous system (CNS) lymphoma treatment has been the convincing data that high-dose methotrexate-based chemotherapy regimens improve survival compared to historical controls treated with radiotherapy alone. However, the optimal treatment approach is still unclear and therapy can be associated with long-term neurotoxicity. Current research focuses on maximizing survival while minimizing neurologic sequelae.

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