Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma
AIM To develop and assess a protocol for the treatment of intraocular lymphoma by intravitreal injection of methotrexate and thiotepa. METHODS A patient with intraocular non-Hodgkin’s lymphoma which recurred after radiotherapy and repeated systemic chemotherapeutic regimens underwent repeated intrav...
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| Veröffentlicht in: | British journal of ophthalmology 1999-04, Vol.83 (4), p.448-451 |
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| creator | de Smet, Marc D Vancs, Virginia Stark Kohler, David Solomon, Diane Chan, Chi Chao |
| description | AIM To develop and assess a protocol for the treatment of intraocular lymphoma by intravitreal injection of methotrexate and thiotepa. METHODS A patient with intraocular non-Hodgkin’s lymphoma which recurred after radiotherapy and repeated systemic chemotherapeutic regimens underwent repeated intravitreal injections of methotrexate and thiotepa. The patient was closely monitored by cytology, anterior chamber flare measurements, IL-10 and IL-6 levels. Methotrexate drug clearance studies were performed on vitreous samples taken before each injection. RESULTS Complete tumour clearance was achieved by the third week of therapy. IL-10 and IL-6 levels quickly dropped to barely detectable levels as the tumour was cleared from the eye. Flare measurements decreased from 500 to 15 photons/s over the same time. A plot of the methotrexate levels over time revealed a first order kinetic rate of elimination with an effective tumoricidal intravitreal dose persisting for 5 days after injection. CONCLUSION Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma appears effective in prolonging local remission of ocular disease even in the presence of an aggressively growing tumour. A single intravitreal injection of methotrexate can lead to a prolonged tumoricidal concentration lasting for a longer period than that achieved by systemic administration. |
| doi_str_mv | 10.1136/bjo.83.4.448 |
| format | Article |
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METHODS A patient with intraocular non-Hodgkin’s lymphoma which recurred after radiotherapy and repeated systemic chemotherapeutic regimens underwent repeated intravitreal injections of methotrexate and thiotepa. The patient was closely monitored by cytology, anterior chamber flare measurements, IL-10 and IL-6 levels. Methotrexate drug clearance studies were performed on vitreous samples taken before each injection. RESULTS Complete tumour clearance was achieved by the third week of therapy. IL-10 and IL-6 levels quickly dropped to barely detectable levels as the tumour was cleared from the eye. Flare measurements decreased from 500 to 15 photons/s over the same time. A plot of the methotrexate levels over time revealed a first order kinetic rate of elimination with an effective tumoricidal intravitreal dose persisting for 5 days after injection. CONCLUSION Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma appears effective in prolonging local remission of ocular disease even in the presence of an aggressively growing tumour. A single intravitreal injection of methotrexate can lead to a prolonged tumoricidal concentration lasting for a longer period than that achieved by systemic administration.</description><identifier>ISSN: 0007-1161</identifier><identifier>EISSN: 1468-2079</identifier><identifier>DOI: 10.1136/bjo.83.4.448</identifier><identifier>PMID: 10434868</identifier><identifier>CODEN: BJOPAL</identifier><language>eng</language><publisher>BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Cellular biology ; Chemotherapy ; Cytarabine - administration & dosage ; Eye ; Eye Neoplasms - drug therapy ; Eye Neoplasms - metabolism ; Female ; Glaucoma ; Humans ; Injections - methods ; Interleukin-10 - metabolism ; Interleukin-6 - metabolism ; intravitreal methotrexate ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse - drug therapy ; Lymphoma, Large B-Cell, Diffuse - metabolism ; Medical sciences ; Methotrexate - administration & dosage ; Middle Aged ; Neoplasm Recurrence, Local - drug therapy ; non-Hodgkin’s lymphoma ; Original articles - Clinical science ; pharmacokinetics ; Pharmacology. Drug treatments ; Radiation therapy ; Review boards</subject><ispartof>British journal of ophthalmology, 1999-04, Vol.83 (4), p.448-451</ispartof><rights>British Journal of Ophthalmology</rights><rights>1999 INIST-CNRS</rights><rights>Copyright: 1999 British Journal of Ophthalmology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b573t-b15bd2a5a7314795de1167d7337e8fc1e40fb7fcaa77f588a0f02d8c4f635c523</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722988/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1722988/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1739349$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10434868$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Smet, Marc D</creatorcontrib><creatorcontrib>Vancs, Virginia Stark</creatorcontrib><creatorcontrib>Kohler, David</creatorcontrib><creatorcontrib>Solomon, Diane</creatorcontrib><creatorcontrib>Chan, Chi Chao</creatorcontrib><title>Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma</title><title>British journal of ophthalmology</title><addtitle>Br J Ophthalmol</addtitle><description>AIM To develop and assess a protocol for the treatment of intraocular lymphoma by intravitreal injection of methotrexate and thiotepa. METHODS A patient with intraocular non-Hodgkin’s lymphoma which recurred after radiotherapy and repeated systemic chemotherapeutic regimens underwent repeated intravitreal injections of methotrexate and thiotepa. The patient was closely monitored by cytology, anterior chamber flare measurements, IL-10 and IL-6 levels. Methotrexate drug clearance studies were performed on vitreous samples taken before each injection. RESULTS Complete tumour clearance was achieved by the third week of therapy. IL-10 and IL-6 levels quickly dropped to barely detectable levels as the tumour was cleared from the eye. Flare measurements decreased from 500 to 15 photons/s over the same time. A plot of the methotrexate levels over time revealed a first order kinetic rate of elimination with an effective tumoricidal intravitreal dose persisting for 5 days after injection. CONCLUSION Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma appears effective in prolonging local remission of ocular disease even in the presence of an aggressively growing tumour. A single intravitreal injection of methotrexate can lead to a prolonged tumoricidal concentration lasting for a longer period than that achieved by systemic administration.</description><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cellular biology</subject><subject>Chemotherapy</subject><subject>Cytarabine - administration & dosage</subject><subject>Eye</subject><subject>Eye Neoplasms - drug therapy</subject><subject>Eye Neoplasms - metabolism</subject><subject>Female</subject><subject>Glaucoma</subject><subject>Humans</subject><subject>Injections - methods</subject><subject>Interleukin-10 - metabolism</subject><subject>Interleukin-6 - metabolism</subject><subject>intravitreal methotrexate</subject><subject>Lymphoma</subject><subject>Lymphoma, Large B-Cell, Diffuse - drug therapy</subject><subject>Lymphoma, Large B-Cell, Diffuse - metabolism</subject><subject>Medical sciences</subject><subject>Methotrexate - administration & dosage</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>non-Hodgkin’s lymphoma</subject><subject>Original articles - Clinical science</subject><subject>pharmacokinetics</subject><subject>Pharmacology. 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Drug treatments</topic><topic>Radiation therapy</topic><topic>Review boards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Smet, Marc D</creatorcontrib><creatorcontrib>Vancs, Virginia Stark</creatorcontrib><creatorcontrib>Kohler, David</creatorcontrib><creatorcontrib>Solomon, Diane</creatorcontrib><creatorcontrib>Chan, Chi Chao</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Smet, Marc D</au><au>Vancs, Virginia Stark</au><au>Kohler, David</au><au>Solomon, Diane</au><au>Chan, Chi Chao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma</atitle><jtitle>British journal of ophthalmology</jtitle><addtitle>Br J Ophthalmol</addtitle><date>1999-04-01</date><risdate>1999</risdate><volume>83</volume><issue>4</issue><spage>448</spage><epage>451</epage><pages>448-451</pages><issn>0007-1161</issn><eissn>1468-2079</eissn><coden>BJOPAL</coden><abstract>AIM To develop and assess a protocol for the treatment of intraocular lymphoma by intravitreal injection of methotrexate and thiotepa. METHODS A patient with intraocular non-Hodgkin’s lymphoma which recurred after radiotherapy and repeated systemic chemotherapeutic regimens underwent repeated intravitreal injections of methotrexate and thiotepa. The patient was closely monitored by cytology, anterior chamber flare measurements, IL-10 and IL-6 levels. Methotrexate drug clearance studies were performed on vitreous samples taken before each injection. RESULTS Complete tumour clearance was achieved by the third week of therapy. IL-10 and IL-6 levels quickly dropped to barely detectable levels as the tumour was cleared from the eye. Flare measurements decreased from 500 to 15 photons/s over the same time. A plot of the methotrexate levels over time revealed a first order kinetic rate of elimination with an effective tumoricidal intravitreal dose persisting for 5 days after injection. CONCLUSION Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma appears effective in prolonging local remission of ocular disease even in the presence of an aggressively growing tumour. A single intravitreal injection of methotrexate can lead to a prolonged tumoricidal concentration lasting for a longer period than that achieved by systemic administration.</abstract><cop>BMA House, Tavistock Square, London, WC1H 9JR</cop><pub>BMJ Publishing Group Ltd</pub><pmid>10434868</pmid><doi>10.1136/bjo.83.4.448</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Cellular biology Chemotherapy Cytarabine - administration & dosage Eye Eye Neoplasms - drug therapy Eye Neoplasms - metabolism Female Glaucoma Humans Injections - methods Interleukin-10 - metabolism Interleukin-6 - metabolism intravitreal methotrexate Lymphoma Lymphoma, Large B-Cell, Diffuse - drug therapy Lymphoma, Large B-Cell, Diffuse - metabolism Medical sciences Methotrexate - administration & dosage Middle Aged Neoplasm Recurrence, Local - drug therapy non-Hodgkin’s lymphoma Original articles - Clinical science pharmacokinetics Pharmacology. Drug treatments Radiation therapy Review boards |
| title | Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma |
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