Activity of high-dose cyclophosphamide in the treatment of childhood malignant gliomas.
Seventeen patients less than or equal to 20 years of age with newly diagnosed (n = 10) or recurrent (n = 7) malignant gliomas (anaplastic astrocytoma and glioblastoma multiforme) were treated with cyclophosphamide in association with hematopoietic cytokines (GM-CSF or G-CSF). Cyclophosphamide was given at a dose of 2 g/m2 daily for 2 days at 4-week intervals. Toxicity consisted of grade IV neutropenia and thrombocytopenia in 95% and 48% of cycles, respectively. There were no cyclophosphamide-related cardiac, pulmonary, or urothelial toxicities observed. Four of 10 patients with newly diagnosed disease demonstrated responses (three complete and one partial responses; one CR was only of 2 months duration). None of the seven patients with recurrent tumors demonstrated a response. We conclude that high-dose cyclophosphamide warrants further evaluation in children with newly diagnosed malignant glioma.
McCowage, GB; Friedman, HS; Moghrabi, A; Kerby, T; Ferrell, L; Stewart, E; Duncan-Brown, M; Fuchs, HE; Tien, R; McLendon, RE; Meier, L; Kurtzberg, J; Ashley, D; Colvin, OM; Longee, DC
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