Use of rituximab in lymphomatoid granulomatosis with isolated central nervous system involvement

2020 ◽  
Vol 13 (9) ◽  
pp. e235412
Author(s):  
Jesse Mooneyham ◽  
Cesar Gentille ◽  
Andrea Barbieri ◽  
Shilpan Shah
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Single Agent ◽  
Central Nervous System Involvement ◽  
Brain Lesions ◽  
The Body ◽  
Lymphomatoid Granulomatosis ◽  
Vasogenic Oedema ◽  
The Central Nervous System

A 33-year-old woman presented to the emergency room with severe headaches. A CT scan of the head revealed two brain lesions with associated vasogenic oedema. Diagnostic resection of one of the lesions followed by pathological analysis revealed grade III lymphomatoid granulomatosis (LYG). Staging investigations elsewhere in the body were negative, isolating this case of LYG to the central nervous system, an atypical presentation. After the resection, she was treated with single-agent rituximab 375 mg/m2. The follow-up MRI demonstrated the resolution of brain lesions and no progression of the disease.

scholarly journals EXTH-77. ONC201 EXHIBITS PASSIVE DIFFUSION AND BROAD DISTRIBUTION IN THE CENTRAL NERVOUS SYSTEM

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii104-ii104
Author(s):  
Sara Morrow ◽  
Varun Prabhu ◽  
Rohinton S Tarapore ◽  
Gina Theerman ◽  
Leah Lake ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Clinical Trials ◽  
Nervous System ◽  
Single Agent ◽  
Passive Diffusion ◽  
The Body ◽  
Whole Body ◽  
Distribution Profile ◽  
Apparent Permeability ◽  
The Central Nervous System

Abstract Imipridone ONC201 is an investigational agent in phase II clinical trials for H3 K27M-mutant diffuse midline glioma with evidence of durable objective responses and clinical symptom improvements as a single agent. The systemic pharmacokinetics of ONC201 and its ability to achieve target concentrations in supratentorial glioblastoma have been demonstrated in clinical trials; however, its clearance and distribution in midline structures and other areas of the central nervous system (CNS) haven’t been evaluated. A quantitative whole-body autoradiography study was conducted in Long-Evans rats with a single dose of [14C]-ONC201. [14C]-ONC201-related material was rapidly distributed throughout the body, with concentrations peaking at 1h for most tissues. The endocrine, metabolic/excretory, ocular and gastrointestinal tract tissues contained the highest distribution of [14C]-ONC201-derived radioactivity. Importantly, [14C]-ONC201 material was distributed evenly across brain substructures, including the meninges and midline structures of the brain; all tissues had a half-life of 1.4–7.9h, with the exception of the meninges (2397.3h). Given the uniform distribution throughout the CNS, we evaluated the permeability and efflux potential of ONC201 in bidirectional transport assays using human Caco-2 cell monolayers. ONC201 displayed high permeability in the apical to basolateral direction with apparent permeability values of 23–31×10–6 cm/s at 7–700μM. In the basolateral to apical direction, apparent permeability values were 11–24 × 10–6 cm/s. The efflux ratio values were 0.46–0.79 for ONC201, suggesting that ONC201 is not a substrate of efflux transporters. However, ONC201 exerted inhibitory potential on MDR1- (90.6%) and BCRP-mediated (81.6%) transport at 200mM. In summary, ONC201 exhibits passive diffusion without being effluxed, which may enable its rapid and wide distribution throughout the CNS. This distribution profile suggests that the compound may achieve therapeutic concentrations throughout the CNS with oral administration and that investigation of additional CNS tumors will not be hindered by drug delivery to specific anatomic structures.

scholarly journals Biomarkers of Central Nervous System Involvement from Epithelial Ovarian Cancer

Cells ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 3408
Author(s):  
Giulia Scotto ◽  
Fulvio Borella ◽  
Margherita Turinetto ◽  
Valentina Tuninetti ◽  
Anna A. Valsecchi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Epithelial Ovarian Cancer ◽  
Hormone Receptors ◽  
Central Nervous System Involvement ◽  
Figo Stage ◽  
The Central Nervous System

Epithelial ovarian cancer (EOC) is the leading cause of death among women affected by gynaecological malignancies. Most patients show advanced disease at diagnosis (FIGO stage III-IV) and, despite the introduction of new therapeutic options, most women experience relapses. In most cases, recurrence is abdominal-pelvic; however, EOC can occasionally metastasize to distant organs, including the central nervous system. The incidence of brain metastases (BMs) from EOC is low, but it has grown over time; currently, there are no follow-up strategies available. In the last decade, a few biomarkers able to predict the risk of developing BMs from OC or as potential therapeutic targets have been investigated by several authors; to date, none have entered clinical practice. The purpose of this review is to offer a summary on the role of the most relevant predictors of central nervous system (CNS) involvement (hormone receptors; BRCA; MRD1; PD-1/PD-L1) and to highlight possible therapeutic strategies for the management of metastatic brain disease in EOC

scholarly journals Fatal Orbital Pyoderma Gangrenosum with Central Nervous System Involvement

2018 ◽  
Vol 76 (4) ◽  
pp. 435-438
Author(s):  
Sofia Lopes ◽  
Júlia Vide ◽  
Sofia Magina ◽  
Ana Paula Cunha ◽  
Filomena Azevedo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pyoderma Gangrenosum ◽  
Central Nervous System Involvement ◽  
Chronic Inflammatory Disease ◽  
The Body ◽  
Response To Treatment ◽  
Insufficient Response ◽  
The Central Nervous System ◽  
Worse Prognosis

Pyoderma gangrenosum is a chronic inflammatory disease characterized by the development of a painful deep ulcer with undermined borders. Head and neck are rarely affected regions of the body and also usually associated with a worse prognosis. Corticosteroids are the mainstay of treatment although available options are not specific nor completely effective in pyoderma gangrenosum. We report the case of a 46-year-old patient with an aggressive orbital pyoderma gangrenosum with progressive extension to the central nervous system and insufficient response to treatment, ultimately leading to patient’s death.

scholarly journals Multiple Myeloma of the Central Nervous System: 13 Cases and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Gergely Varga ◽  
Gábor Mikala ◽  
László Gopcsa ◽  
Zoltán Csukly ◽  
Sarolta Kollai ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Multiple Myeloma ◽  
Nervous System ◽  
Case Reports ◽  
Rare Complication ◽  
Clonal Evolution ◽  
Central Nervous System Involvement ◽  
Review Of The Literature ◽  
The Central Nervous System

Central nervous system involvement is a rare complication of multiple myeloma with extremely poor prognosis as it usually fails to respond to therapy. We present 13 cases diagnosed at two centers in Budapest and review the current literature. The majority of our cases presented with high-risk features initially; two had plasma cell leukemia. Repeated genetic tests showed clonal evolution in 3 cases. Treatments varied according to the era, and efficacy was poor as generally reported in the literature. Only one patient is currently alive, with 3-month follow-up, and the patient responded to daratumumab-based treatment. Recent case reports show promising effectivity of pomalidomide and marizomib.

Characteristics of the dynamics of the central nervous system and att ention function in workers of shoe production

2020 ◽  
pp. 64-68
Author(s):  
F. L. Azizova ◽  
U. A. Boltaboev
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Women Workers ◽  
Functional State ◽  
The Body ◽  
Conflict Of Interests ◽  
Professional Groups ◽  
Universal Device ◽  
The Central Nervous System ◽  
Working Day

The features of production factors established at the main workplaces of shoe production are considered. The materials on the results of the study of the functional state of the central nervous system of women workers of shoe production in the dynamics of the working day are presented. The level of functional state of the central nervous system was determined by the speed of visual and auditory-motor reactions, installed using the universal device chronoreflexometer. It was revealed that in the body of workers of shoe production there is an early development of inhibitory processes in the central nervous system, which is expressed in an increase in the number of errors when performing tasks on proofreading tables. It was found that the most pronounced shift s in auditory-motor responses were observed in professional groups, where higher levels of noise were registered in the workplace. The correlation analysis showed a close direct relationship between the growth of mistakes made in the market and the decrease in production. An increase in the time spent on the task indicates the occurrence and growth of production fatigue.Funding. The study had no funding.Conflict of interests. The authors declare no conflict of interests.

Neural Stem Cells to Glial Cells an Important Factor for Brain Injury

2020 ◽  
Author(s):  
Prithiv K R Kumar
Keyword(s):  
Stem Cells ◽  
Central Nervous System ◽  
Nervous System ◽  
Neural Stem Cells ◽  
Glial Cells ◽  
Brain Injuries ◽  
The Body ◽  
The Central Nervous System ◽  
Near Future

Stem cells have the capacity to differentiate into any type of cell or organ. Stems cell originate from any part of the body, including the brain. Brain cells or rather neural stem cells have the capacitive advantage of differentiating into the central nervous system leading to the formation of neurons and glial cells. Neural stem cells should have a source by editing DNA, or by mixings chemical enzymes of iPSCs. By this method, a limitless number of neuron stem cells can be obtained. Increase in supply of NSCs help in repairing glial cells which in-turn heal the central nervous system. Generally, brain injuries cause motor and sensory deficits leading to stroke. With all trials from novel therapeutic methods to enhanced rehabilitation time, the economy and quality of life is suppressed. Only PSCs have proven effective for grafting cells into NSCs. Neurons derived from stem cells is the only challenge that limits in-vitro usage in the near future.

scholarly journals Treatment of secondary central nervous system involvement in systemic aggressive B cell lymphoma using R-MIADD chemotherapy: a single-center study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuchen Wu ◽  
Xuefei Sun ◽  
Xueyan Bai ◽  
Jun Qian ◽  
Hong Zhu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Involvement ◽  
Central Nervous System Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Cns Involvement ◽  
The Central Nervous System ◽  
Secondary Central Nervous System

Abstract Background Secondary central nervous system lymphoma (SCNSL) is defined as lymphoma involvement within the central nervous system (CNS) that originated elsewhere, or a CNS relapse of systemic lymphoma. Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined. Methods We conducted a retrospective study to assess the feasibility of an R-MIADD (rituximab, high-dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, and dexamethasone) regimen for SCNSL patients. Results Nineteen patients with newly diagnosed CNS lesions were selected, with a median age of 58 (range 20 to 72) years. Out of 19 patients, 11 (57.9%) achieved complete remission (CR) and 2 (10.5%) achieved partial remission (PR); the overall response rate was 68.4%. The median progression-free survival after CNS involvement was 28.0 months (95% confidence interval 11.0–44.9), and the median overall survival after CNS involvement was 34.5 months. Treatment-related death occurred in one patient (5.3%). Conclusions These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL, further investigation is warranted.

scholarly journals VI. —Anaphylaxis and anaphylatoxins

1923 ◽  
Vol 211 (382-390) ◽  
pp. 273-315 ◽  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Guinea Pig ◽  
Anaphylactic Shock ◽  
The Body ◽  
Muscle Fibres ◽  
Direct Stimulation ◽  
Fundamental Conception ◽  
The Central Nervous System ◽  
Stimulation Of

In the study of the phenomena of anaphylaxis there are certain points on which some measure of agreement seems to have been attained. In the case of anaphylaxis to soluble proteins, with which alone we are directly concerned in this paper, the majority of investigators probably accept the view that the condition is due to the formation of an antibody of the precipitin type. Concerning the method, however, by which the presence of this antibody causes the specific sensitiveness, the means by which its interaction with the antibody produces the anaphylactic shock, there is a wide divergence of conception. Two main currents of speculation can be discerned. One view, historically rather the earlier, and first put forward by Besredka (1) attributes the anaphylactic condition to the location of the antibody in the body cells. There is not complete unanimity among adherents of this view as to the nature of the antibody concerned, or as to the class of cells containing it which are primarily affected in the anaphylactic shock. Besredka (2) himself has apparently not accepted the identification of the anaphylactic antibody with a precipitin, but regards it as belonging to a special class (sensibilisine). He also regards the cells of the central nervous system as those primarily involved in the anaphylactic shock in the guinea-pig. Others, including one of us (3), have found no adequate reason for rejecting the strong evidence in favour of the precipitin nature of the anaphylactic antibody, produced by Doerr and Russ (4), Weil (5), and others, and have accepted and confirmed the description of the rapid anaphylactic death in the guinea-pig as due to a direct stimulation of the plain-muscle fibres surrounding the bronchioles, causing valve-like obstruction of the lumen, and leading to asphyxia, with the characteristic fixed distension of the lungs, as first described by Auer and Lewis (6), and almost simultaneously by Biedl and Kraus (7). But the fundamental conception of anaphylaxis as due to cellular location of an antibody, and of the reaction as due to the union of antigen and antibody taking place in the protoplasm, is common to a number of workers who thus differ on details.

Solitary Fibrous Tumors in the Central Nervous System

2003 ◽  
Vol 127 (4) ◽  
pp. 432-439 ◽  
Author(s):  
Tarik Tihan ◽  
Michael Viglione ◽  
Marc K. Rosenblum ◽  
Alessandro Olivi ◽  
Peter C. Burger
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Biological Behavior ◽  
Clinicopathologic Features ◽  
Distinct Entity ◽  
Total Resection ◽  
Solitary Fibrous Tumors ◽  
The Central Nervous System ◽  
Extracranial Metastases

Abstract Context.—Solitary fibrous tumors (SFTs) of the central nervous system are rare neoplasms that usually present as dura-based masses and clinically resemble meningiomas. Histologically, they can be similar to fibrous meningioma or hemangiopericytoma (HPC). In particular, densely cellular regions seen in some SFTs can be indistinguishable from HPC. Little is known about the biological behavior of SFTs, although most seem amenable to total resection. Objectives.—To define the clinicopathologic spectrum of SFTs in the central nervous system and to outline their differences from HPC and meningioma. Design.—We present the clinicopathologic features of 18 patients with SFT and compare them with those of an age- and sex-matched cohort of HPCs. Results.—Eleven SFTs were supratentorial, 3 were infratentorial, and 4 were intraspinal. Four of the 18 tumors were intra-axial (2 in the lateral ventricles and 2 within the spinal cord). Histologically, SFTs were similar to their soft tissue counterparts. Six tumors (6/18) had densely cellular regions, and 1 tumor showed frankly anaplastic features. All but 3 patients underwent gross total resection, and there were no metastases or tumor-related mortalities during the median follow-up of 40 months. In contrast, there were 15 local recurrences (83%), 5 extracranial metastases (27%), and 4 tumor-related deaths (22%) in the HPC cohort. Conclusions.—Our study presents the clinicopathologic features of SFT as a distinct entity from both meningioma and HPC. We also present unusual examples of anaplastic, intraventricular, and intramedullary spinal SFTs that expand the clinicopathologic spectrum of these uncommon and sometimes diagnostically difficult neoplasms.

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