| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Clinical Trials |
Massachusetts General Hospital Brain Tumor Center and Neurology Service, Massachusetts General Hospital, Boston, Massachusetts 02114 [T. T. B., G. K., R. C., J. W. H.]; Department of Neurology, Harvard Medical School, Boston, Massachusetts 02108 [T. T. B., R. C., J. W. H.]; and Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114 [C. S. F.]
Purpose: Intraocular lymphoma (IOL) frequently coexists with primary central nervous system lymphoma(PCNSL). We sought to determine the efficacy of high-dose methotrexate (MTX) alone in patients with IOL. We also sought to determine whether micromolar levels of MTX could be achieved in the aqueous and vitreous humor of the eye after i.v. administration of the drug.
Experimental Design: Nine patients with concurrent PCNSL and IOL or isolated IOL were treated with MTX alone. All patients were treated with i.v. 8 g/m2 MTX. MTX concentrations in serum, aqueous humor, and vitreous humor were obtained in seven of nine patients with IOL and in one additional patient with PCNSL but no evidence of IOL.
Results: Micromolar concentrations of MTX were present in both ocular chambers 4 h after completion of the infusion in eight of eight patients. Levels of MTX were lower in the vitreous humor compared with the aqueous humor in five of six patients in whom both chambers were assayed. Initial response of IOL to MTX was demonstrated by seven of nine patients (six complete responses and one partial response), whereas two patients had persistent IOL despite achievement of micromolar concentrations of MTX. In the patients with concurrent PCNSL and IOL, seven of seven had complete responses in the brain after treatment with MTX. Three of seven patients with initial response of IOL experienced relapse in the eye requiring orbital radiation, and four of nine patients had sustained response of IOL to MTX.
Conclusions: A subset of patients with IOL may experience sustained remission when treated with high-dose i.v. MTX alone. Although micromolar MTX concentrations are present in the eye 4 h after infusion, the lower concentration achieved in vitreous humor may contribute to persistence of IOL.
This article has been cited by other articles:
|
|
 |
|
  J. Martin, P. Malreddy, T. Iwamoto, L. C. Freeman, H. J. Davidson, J. M. Tomich, and B. D. Schultz NC-1059: A Channel-Forming Peptide That Modulates Drug Delivery across In Vitro Corneal Epithelium Invest. Ophthalmol. Vis. Sci., July 1, 2009; 50(7): 3337 - 3345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-J. Zhu, E. R. Gerstner, D. A. Engler, M. M. Mrugala, W. Nugent, K. Nierenberg, F. H. Hochberg, R. A. Betensky, and T. T. Batchelor High-dose methotrexate for elderly patients with primary CNS lymphoma Neuro-oncol, January 1, 2009; 11(2): 211 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Grimm, C. A. McCannel, A.M.P. Omuro, A. J.M. Ferreri, J. -Y. Blay, E. A. Neuwelt, T. Siegal, T. Batchelor, K. Jahnke, T. N. Shenkier, et al. Primary CNS lymphoma with intraocular involvement: International PCNSL Collaborative Group Report Neurology, October 21, 2008; 71(17): 1355 - 1360. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Frenkel, K Hendler, T Siegal, E Shalom, and J Pe'er Intravitreal methotrexate for treating vitreoretinal lymphoma: 10 years of experience Br. J. Ophthalmol., March 1, 2008; 92(3): 383 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. M. DeAngelis and F. M. Iwamoto An Update on Therapy of Primary Central Nervous System Lymphoma Hematology, January 1, 2006; 2006(1): 311 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Jahnke, T. Wagner, N. E. Bechrakis, G. Willerding, S. E. Coupland, L. Fischer, E. Thiel, and A. Korfel Pharmacokinetics and efficacy of ifosfamide or trofosfamide in patients with intraocular lymphoma Ann. Onc., December 1, 2005; 16(12): 1974 - 1978. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hon, R. W. Law, T. W. Shek, and W. Y. Au CNS Manifestations of Malignancies: CASE 1. Conjunctival Relapse of Acute Lymphoblastic Leukemia Heralding Pituitary and CNS Disease J. Clin. Oncol., June 20, 2005; 23(18): 4225 - 4226. [Full Text] [PDF]
|
|
|
|
|
|
A. J.M. Ferreri, L. E. Abrey, J.-Y. Blay, B. Borisch, J. Hochman, E. A. Neuwelt, J. Yahalom, E. Zucca, F. Cavalli, J. Armitage, et al. Summary Statement on Primary Central Nervous System Lymphomas From the Eighth International Conference on Malignant Lymphoma, Lugano, Switzerland, June 12 to 15, 2002 J. Clin. Oncol., June 15, 2003; 21(12): 2407 - 2414. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Cancer Research | Clinical Cancer Research |
| Cancer Epidemiology Biomarkers & Prevention | Molecular Cancer Therapeutics |
| Molecular Cancer Research | Cancer Prevention Research |
| Cancer Prevention Journals Portal | Cancer Reviews Online |
| Annual Meeting Education Book | Meeting Abstracts Online |
