melphalan and Meningeal-Neoplasms

Topics: Acute Kidney Injury; Altretamine; Anemia; Bacterial Infections; Bone Neoplasms; Cyclophosphamide; Doxorubicin; Drug Therapy, Combination; Humans; Hypercalcemia; Interferons; Kidney Failure, Chronic; Melphalan; Meningeal Neoplasms; Multiple Myeloma; Spinal Cord Compression; Vinblastine; Vincristine; Vindesine

Topics: Angiogenesis Inhibitors; Antineoplastic Combined Chemotherapy Protocols; Doxorubicin; Etoposide; Fatal Outcome; Female; Humans; Immunoglobulin G; Melphalan; Meningeal Neoplasms; Middle Aged; Multiple Myeloma; Nitrosourea Compounds; Prednisolone; Prednisone; Thalidomide; Vindesine

A 52-year-old woman was admitted to the gynecological department of our hospital on July 29, 2002 because of a right lower abdominal mass. She has been suffering from pain in the right leg and inguinal area for a month before coming to the hospital. She was found to have pancytopenia and high serum levels of LDH and IgD. A bone marrow examination showed 63.8% of plasma cells and serum immunoelectrophoresis showed M-protein of the IgD-lambda type. She was diagnosed as having multiple myeloma and transferred to our department. VAD therapy was started from August 22. Although the plasma cells in the bone marrow almost disappeared, the right lower abdominal mass remained and a new mass appeared on the right frontal chest wall after two courses of the treatment. Combination chemotherapy with vincristine, ranimustine, melphalan, and dexamethasone (ROAD) was started on November 1. This was followed with thalidomide and radiation therapy of the right inguinal region was added. On December 16th, she suddenly experienced speech disturbance, nausea and the disturbance of consciousness. Examination of her cerebrospinal fluid showed 368/microl mononuclear cells with 93% plasma cells. The plasma cells disappeared after the 6th intrathecal injection with MTX and prednisolone and the chemotherapy was resumed. One month later, CNS relapse was apparent followed by generalized spread of the tumor mass, and she died on March 17, 2003.

Topics: Antineoplastic Combined Chemotherapy Protocols; Biomarkers; Dexamethasone; Doxorubicin; Drug Therapy, Combination; Fatal Outcome; Female; Humans; Immunoglobulin D; Injections, Spinal; Interferon-alpha; Melphalan; Meningeal Neoplasms; Methotrexate; Middle Aged; Multiple Myeloma; Myeloma Proteins; Neoplasm Invasiveness; Nitrosourea Compounds; Prednisolone; Radiotherapy, Adjuvant; Thalidomide; Vincristine

Topics: Antineoplastic Agents, Alkylating; Female; Fluorodeoxyglucose F18; Humans; Leukemia, Myeloid; Melphalan; Meningeal Neoplasms; Middle Aged; Neoplasms, Second Primary; Thrombocytosis; Tomography, Emission-Computed

Interdisciplinary protocols for management of advanced adenocarcinoma of the ovary have resulted in prolonged patient survival. A subset of patients is emerging in whom central nervous system (CNS) relapse occurs even following negative second-look procedures (SLP). Seven of 342 eligible patients entered in a National Cancer Institute of Canada Trial for Ovarian Cancer, from February 1, 1980 to March 31, 1984, had CNS relapse. All patients received adriamycin and cisplatin. SLP was performed in 5 patients, 3 of whom were complete responders (CR). Two additional patients failed to complete their chemotherapy and had progressive pelvic disease. The median age of these 7 patients was 57 years, their overall survival time was 28 months, compared with an average age of 58 years and survival of 21.6 months, for the entire group. Two patients had prolonged survival after their CNS relapse; 1 patient lived 26 months, and the other, who underwent craniotomy for primary management of the metastasis survived 18 months. Confirmation of metastatic disease was obtained in 4 of the 7 patients. The results of this study suggest that management of CNS involvement in adenocarcinoma of the ovary should be determined by overall performance status even in the presence of generalized disease.

Topics: Adenocarcinoma; Aged; Altretamine; Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Cisplatin; Combined Modality Therapy; Doxorubicin; Female; Humans; Melphalan; Meningeal Neoplasms; Middle Aged; Ovarian Neoplasms