RESUMO
After treating a child suffering from disseminated primitive neuroectodermal tumor and hydrocephalus with bilateral ventriculostomies, we administered intravenous high dose thiotepa followed by a single subcutaneous dose of GM-CSF 24 hours later. The appearance and clearance of GM-CSF were measured from both ventricles, one of which was surrounded by tumor. Peak levels of GM-CSF were recorded simultaneously in both ventricles 11 hours after injection. Complete clearance from injection required 15 hours and 31 hours for the tumor-free right ventricle and the tumor-involved left ventricular wall, respectively. Tumor response was ephemeral and limited to ventricular fluid WBC, protein and LDH decreases. Microglia were detected; however, there was no evidence of anti-tumor activity in biopsied tumor tissue. Tumored regions of the brain may have perturbation of GM-CSF distribution and clearance which may contribute to the lack of microglial activity.
