Neuropsychological assessment outcomes of nonacquired immunodeficiency syndrome patients with primary central nervous system lymphoma before and after blood-brain barrier disruption chemotherapy

John R. Crossen, David L. Goldman, Suellen A. Dahlborg, Edward A. Neuwelt

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

The risk of neurotoxicity was evaluated in eight consecutive patients with non-acquired immunodeficiency syndrome (AIDS) primary central nervous system lymphoma who had survived disease free for more than 1 year after completion of treatment with osmotic opening of the blood-brain barrier and chemotherapy (methotrexate, cytoxan, procarbazine, and decadron). Trends in neuropsychological assessment results between baseline and follow-up (1 to 7 years) were analyzed for all eight nonradiated survivors. This serial assessment design addressed the specific issue of neurotoxic risk potential of treatment, when confounding factors of tumor persistence/recurrence and cranial irradiation were ruled out. Follow-up results of an extensive battery of tests to assess higher cortical function provided evidence of the safety of chemotherapy protocol with the blood-brain barrier disruption. These findings stand in contrast to well-known cognitive risks associated with cranial radiotherapy. Long-term follow-up suggests that chemotherapy can be given in conjunction with osmotic opening of the blood-brain barrier in nonradiated patients without cognitive manifestations of neurotoxicity.

Original languageEnglish (US)
Pages (from-to)23-29
Number of pages7
JournalNeurosurgery
Volume30
Issue number1
DOIs
StatePublished - Jan 1992

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Keywords

  • Blood-brain barrier
  • Brain cancer
  • Neuropsychological assessment
  • Primary central nervous system lymphoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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