Autologous Bone Marrow Transplantation - Blog Science Connections

Brain Cancer
S. Wolff and G. Herzig, Chairmen
DR. H. VRIESENDORP: Brain tumors are a local problem, not a systemic
disease. Autologous bone marrow transplantation (ABMT) so far has had a
lot of toxic effects and not a lot of useful therapeutic results. Is any consideration
being given to approaching the problem in a local way?
DR. S. WOLFF: I think those directions are being explored, but not by
people undergoing ABMT obviously.
DR. K. DlCKE: When you increase a systemic dose of VP-16-213
(etoposide), do you get higher levels of etoposide in the CMS?
DR. WOLFF: We have looked at CSF levels. We have also had the
opportunity in one patient who had an Ommaya reservoir inside a cystic
neoplasm to sample etoposide levels. There are higher levels compared to
what you would achieve with normal-dose etoposide in those patients, either
in the CSF or in the cystic internal fluid of a high-grade neoplasm. So I think
you do get higher levels into the CNS with high-dose systemic therapy. One of
the reasons that we've done these studies with systemic therapy is that,
although brain tumors are localized processes, they're really not very
localized. They intercollate throughout an extensive part of the brain. Many of
the infusional studies cannot be done because high-grade tumors classically
cross the midline, and I think that one of the things that we're really accepting
now is that this is a fairly extensive neoplasm at the time of diagnosis.
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