rifampin and Brain-Neoplasms

Temozolomide (TMZ) is a cytotoxic agent of the imidazotetrazine class, chemically related to dacarbazine. Its use poses higher risks of lymphopenia and opportunistic infections. Prophylaxis for Pneumocystis jiroveci must be considered up to 12 months after treatment discontinuation. The due literature (MEDLINE) makes no mention of a possible connection between the use of TMZ and tuberculosis (TB). A female patient, aged 59, featuring glioblastoma multiforme and having undergone solely a brain biopsy, was submitted to TMZ along with radiotherapy. After the first TMZ maintenance cycle, the referred patient was admitted displaying a background of a 40-day afternoon fever and productive coughing. She was thus submitted to a bronchoscopy and LBA, which resulted BAAR 1+/4+. TMZ was then suspended, and rifampicin, isoniazid, and pyrazinamide introduced. Considerations on prophylaxis with isoniazide in cancer patients are long-lived and scarce. Some subgroups are likely to benefit from the prophylactic administration of isoniazide during TMZ treatment, such as those patients under high doses of corticoids, patients with past medical history of TB, the malnourished, patients from endemic regions, and patients with highly reactive tuberculinic tests. That, nevertheless, must not restrict the administration of TMZ, but, rather, stand for a warning about its possible toxicity, and thus mitigate complications.

Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Anti-Ulcer Agents; Antibiotics, Antitubercular; Anticholesteremic Agents; Anticonvulsants; Antineoplastic Agents, Alkylating; Atorvastatin; Brain Neoplasms; Combined Modality Therapy; Cyclosporine; Dacarbazine; Dexamethasone; Female; Fluoxetine; Glioblastoma; Heptanoic Acids; Humans; Immunosuppressive Agents; Isoniazid; Middle Aged; Omeprazole; Phenobarbital; Prednisone; Pyrazinamide; Pyrroles; Radiotherapy; Red-Cell Aplasia, Pure; Rifampin; Temozolomide; Trimethoprim, Sulfamethoxazole Drug Combination; Tuberculosis, Pulmonary

Topics: Antitubercular Agents; Brain Neoplasms; Diagnosis, Differential; Female; Glioma; Humans; Isoniazid; Magnetic Resonance Imaging; Middle Aged; Pyrazinamide; Rifampin; Tuberculoma

Nuclear RNA polymerase activity was studied in homotransplanted rat glial tumors where the primary tumor was produced by transplacental injection of ethylnitrosourea. Alpha amanitin, cycloheximide, and rifampicin were tested as inhibitors of this activity. Alpha amanitin significantly inhibited RNA polymerase activity in all tumors. This indicated that the major nuclear RNA polymerase activity seen in vitro in the tumor nuclei was RNA polymerase II. This is similar to the activity seen in normal glial nuclei. Cycloheximide and rifampicin which have no effect on RNA polymerase activity in normal glial nuclei inhibited about 20% of the polymerase activity in three of the tumors. The size and multiplicity of the nucleoli in these tumor cells suggests that RNA polymerase I could account for the activity which is inhibited by cycloheximide.

Topics: Amanitins; Animals; Autoradiography; Brain Neoplasms; Cell Nucleolus; Cell Nucleus; Cycloheximide; DNA-Directed RNA Polymerases; DNA, Neoplasm; Endoplasmic Reticulum; Ethylnitrosourea; Fibrosarcoma; Glioma; Guanosine Triphosphate; Neoplasm Transplantation; Neoplasms, Experimental; Neurofibroma; Rats; Rifampin; Transplantation, Homologous

Topics: Biopsy; Brain Neoplasms; Cell Nucleus; Cycloheximide; DNA-Directed RNA Polymerases; Humans; Mycotoxins; Rifampin