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Maintenance treatment with interferon-gamma and low-dose cyclophosphamide for pediatric high-grade glioma.


Posted on: 05/09/2006

J Neurooncol. 2006 Apr 28; [Epub ahead of print] Related Articles, Links

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Maintenance treatment with interferon-gamma and low-dose cyclophosphamide for pediatric high-grade glioma.

Wolff JE, Wagner S, Reinert C, Gnekow A, Kortmann RD, Kuhl J, Van Gool SW.

Department of Pediatrics, MD Anderson Cancer Center, Unit 87, University of Texas, 1515 Holcombe Blvd, Houston, TX , 77030, USA.

BACKGROUND: The prognosis of high-grade glioma in children is poor. PURPOSE: Interferon-gamma may increase the immune surveillance of glioma cells. Earlier clinical evidence had shown that low dose cyclophosphamide (CPM) increased immune response. METHODS: After induction treatment with simultaneous radiation and chemotherapy, patients were treated with individually increasing interferon-gamma (IFN-gamma) doses starting from 25 microg/m(2)/d s.c. increasing up to a maximum of 175 microg/m(2)/d within 7 weeks. Cyclophosphamide was given at 300 mg/m(2) i.v. every 21 days. Forty pediatric glioma patients were enrolled (median age: 8.5 year, male: n = 22). Tumor locations included cerebral cortex (n = 8), basal ganglia (n = 4), brainstem (n = 24), cerebellum (n = 3), spinal cord (n = 1). Histologies were GBM (n = 14), AA (n = 14), LGG (n = 2, diffuse intrinsic pontine glioma). There was grade IV toxicity for thrombocytopenia (10%) and leucopenia (2.5%), grade III toxicity for central nervous (2.5%) and hepatic (5%) side effects, no toxic death. The observation time of the six surviving patients was: 1.2, 1.9, 4.2, 4.4, 4.6 and 4.7 years respectively. The median overall survival (1 year) was not significantly different from a historical control group (0.8 years). The survival of pontine gliomas appeared even inferior when compared to the previous protocol (n.s.). CONCLUSION: Maintenance treatment with IFN-gamma and low dose CPM has no sufficient beneficial effect for the treatment of high-grade glioma.

PMID: 16645718 [PubMed - as supplied by publisher]

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