Central nervous system pharmacology of antileukemic drugs

The American Journal of Pediatric Hematology/oncology
F M Balis, D G Poplack

Abstract

The blood-brain barrier provides a pharmacologic sanctuary for leukemic cells within the central nervous system (CNS), protecting them from the cytotoxic effects of systemic antileukemic therapy. Attempts to overcome this problem have included specific CNS-directed treatment in the form of direct intrathecal drug injection, cranial irradiation, and alteration in the dose and schedule of systemic agents to enhance their CNS penetration. Use of these treatments and strategies has led to the effective prevention and control of meningeal leukemia. Intrathecal therapy, primarily with methotrexate or cytosine arabinoside, is a form of regional chemotherapy that can achieve very high drug concentrations at the target site [i.e., in the meninges and cerebrospinal fluid (CSF)] with a low total dose. Therefore, there is minimal systemic toxicity. The dose and schedules, clinical pharmacology, and toxicities of the commonly used intrathecal agents are discussed in detail in this article. Another approach to overcoming the limited penetration of antileukemic drugs into the CNS has been the use of high-dose systemic therapy. Methotrexate and cytosine arabinoside in high doses have produced favorable clinical responses in patients with overt...Continue Reading

Citations

Jan 1, 1996·Investigational New Drugs·S M Blaney, D G Poplack
Jan 1, 1992·Cancer Chemotherapy and Pharmacology·M G DonelliM D'Incalci
Aug 30, 2000·Medical Oncology·S M Blaney, D G Poplack
Mar 5, 2013·Current Treatment Options in Oncology·Stephane DoucetJeffrey Raizer
Nov 9, 1991·Clinica Chimica Acta; International Journal of Clinical Chemistry·L VainionpääJ Risteli
Mar 29, 2002·Survey of Ophthalmology·Russell W ReadNarsing A Rao
May 15, 2002·Leukemia Research·Farhad RavandiHagop M Kantarjian
Jun 12, 2003·Ophthalmology·John O Mason, David H Fischer
Jul 2, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·U Basso, A A Brandes
Mar 15, 2001·Critical Reviews in Oncology/hematology·J Z KerrS M Blaney
Sep 1, 1994·Human Gene Therapy·C HesdorfferM Begg
May 12, 2010·Journal of the National Cancer Institute·Nina S Kadan-LottickKevin R Krull
Aug 4, 2009·Journal of Veterinary Internal Medicine·P M SmithN D Jeffery
Sep 9, 2010·Antimicrobial Agents and Chemotherapy·Zhi-Gang JiangEugene O Major
Jan 9, 2010·Annual Review of Pharmacology and Toxicology·Georgios K PaschosGarret A FitzGerald
Jan 9, 2010·Annual Review of Pharmacology and Toxicology·Francis LéviJean Clairambault
Jul 27, 2011·Therapeutic Advances in Medical Oncology·Nooshin Hashemi-Sadraei, David M Peereboom
Dec 1, 2006·Neurosurgical Focus·Oussama Abla, Sheila Weitzman
Jan 11, 2008·AJNR. American Journal of Neuroradiology·M E CareyK L Kaemingk
May 1, 1996·Leukemia & Lymphoma·L H Matherly, J W Taub
Nov 27, 2010·Neurosurgery Clinics of North America·Morris D Groves
Aug 11, 2010·Critical Reviews in Oncology/hematology·Fabio CanovaSavina Maria Luciana Aversa
Apr 9, 2008·Leukemia Research·E G HaarmanA J P Veerman
Jul 25, 2008·International Journal of Cancer. Journal International Du Cancer·Päivi M LähteenmäkiArja Harila-Saari
Aug 9, 2005·Hematology/oncology Clinics of North America·Carole SoussainNancy D Doolittle
Mar 20, 2001·Hematology/oncology Clinics of North America·J Cortes
Sep 11, 2008·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Takeshi YamadaTakashi Tajiri
Jan 28, 2014·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Joost WesterhoutElizabeth C M de Lange
Aug 3, 2010·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Partow KebriaeiBorje S Andersson
Feb 1, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Yvette L KasamonIan W Flinn
Sep 19, 2014·Annals of Hematology·Heidrun BoztugUNKNOWN EBMT paediatric diseases working party
Mar 25, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Wendy LandierSmita Bhatia
May 24, 2017·Leukemia & Lymphoma·Richard A Larson
May 30, 2013·Surgical Neurology International·Emilie Le RhunMarc C Chamberlain
Oct 31, 2000·The Annals of Pharmacotherapy·D J Murry, S M Blaney
May 1, 1995·Journal of Child Neurology·M C Chamberlain
Jan 1, 1997·Journal of Child Neurology·M C Chamberlain
Apr 1, 1994·Journal of Child Neurology·M C Chamberlain

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.