Autologous Bone Marrow Transplantation - Blog Science Connections

Pilot Study of High-Dose Carmustine,
Transplantation, Radiotherapy, and
Surgery for Patients
With Glioma
Pierre Biron, Françoise Mornex, Christophe Vial, Franck Chauvin,
Maurice Veysseyre, Irene Philip, and Thierry Philip
High-grade gliomas of the brain (anaplastic astrocytoma and glioblastoma
multiforme) are the most frequently occurring primary CNS tumors. Despite
conventional treatment including surgical resection, postoperative irradiation,
and adjuvant chemotherapy, the prognosis has remained very poor ( 1 ).
Postoperative irradiation had increased overall survival rates significantly (2).
Attempts to improve these results by using adjuvant mono- or polychemotherapy
improved neither response rate nor survival (3-5). The lack of activity
of chemotherapy in such tumors is explained not only by their low
chemosensitivity but also by low penetration of the drugs into the CNS. One
way to overcome the problem of the so-called blood-brain barrier is to use the
dose-effect relationship and especially high doses of chloroethyl nitrosoureas,
such as carmustine (BCNCJ), which has been proved to be efficient at
conventional dosage (3).
Since 1980 (6), many reports have been published on escalation of dose
for gliomas (7-10). The objective of our pilot study is to evaluate the
feasibility, efficiency, and toxicity of a therapeutic program for patients with
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