Spontaneous regression of residual low-grade cerebellar pilocytic astrocytomas in children

Gunny, Roxana; Hayward, Richard; Phipps, Kim; Harding, Brian; Saunders, Dawn

doi:10.1007/s00247-005-1546-z

Cited by 48 publications

(29 citation statements)

References 31 publications

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“…[19][20][21][22][23] Conversely, to our knowledge only scant data are available regarding piloA occurring in adult patients. 3,16,17 In the current study, we report on a single institution's experience with piloA diagnosed in patients aged > 16 years.…”

Section: Discussionmentioning

confidence: 99%

Frequent recurrence and progression in pilocytic astrocytoma in adults

Stüer

Vilz

Majores

et al. 2007

Cancer

124

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Objective: We compared use of intravenous (IV) normal saline (NS) to sodium bicarbonate (NaHCO3) with or without oral N‐acetylcysteine (NAC) for prevention of contrast‐induced acute kidney injury (CI‐AKI). Background: CI‐AKI is associated with significant adverse clinical events. Use of NAC has produced variable results. Recently, intravenous hydration with NaHCO3 for CI‐AKI prophylaxis has been adopted as standard treatment for patients with stable chronic renal disease undergoing catheterization procedures. Methods: We prospectively enrolled 320 patients with baseline renal insufficiency scheduled to undergo catheterization. Patients were randomly assigned to receive either IV NS ± NAC (n = 161) or IV dextrose 5% in water containing 154 mEq/l of NaHCO3 ± NAC (n = 159). IV NS was administered at 1 ml/kg body weight for 12 hr preprocedure and 12 more hr postprocedure. IV NaHCO3 was administered at 3 ml/kg body weight for 1 hr preprocedure followed by 1 ml/kg body weight postprocedure. A 1,200 mg oral dose of NAC was given 2–12 hr preprocedure and 6–12 hr postprocedure in 50% of patients in each study arm. CI‐AKI was defined as an increase of >0.5 mg/dl or >25% above baseline creatinine. Results: Overall incidence of CI‐AKI was 10.3%. There was no significant difference in incidence among the two groups (NS ± NAC 11.8% vs. NaHCO3 ± NAC 8.8%, p = ns). Incidence of CI‐AKI increased with increasing age (p = 0.001), contrast agent use >3 ml/kg body weight (p = 0.038) and diuretic use (p = 0.005). Conclusion: Incidence of CI‐AKI was no different in the NaHCO3 group compared to NS group, and NAC did not reduce CI‐AKI in the two study arms. © 2011 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Frequent recurrence and progression in pilocytic astrocytoma in adults

Stüer

Vilz

Majores

et al. 2007

Cancer

124

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“…It is therefore anticipated that lack of telomere maintenance will result in tumor growth arrest. Indeed, although spontaneous tumor regression is rare, it has been reported in a subgroup of pediatric neural cancers (lowgrade gliomas and neuroblastomas) in which telomerase activity was not observed (11,12).…”

Section: Introductionmentioning

confidence: 99%

Neural Tumor-Initiating Cells Have Distinct Telomere Maintenance and Can be Safely Targeted for Telomerase Inhibition

Castelo‐Branco

Zhang

Lipman

et al. 2011

Clinical Cancer Research

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Purpose: Cancer recurrence is one of the major setbacks in oncology. Maintaining telomeres is essential for sustaining the limitless replicative potential of such cancers. Because telomerase is thought to be active in all tumor cells and normal stem cells, telomerase inhibition may be nonspecific and have detrimental effects on tissue maintenance and development by affecting normal stem cell self-renewal.Methods: We examined telomerase activity, telomere maintenance, and stem cell maturation in tumor subpopulations from freshly resected gliomas, long-term, primary, neural tumor-initiating cells (TIC) and corresponding normal stem cell lines. We then tested the efficacy of the telomerase inhibitor Imetelstat on propagation and self-renewal capacity of TIC and normal stem cells in vitro and in vivo.Results: Telomerase was undetectable in the majority of tumor cells and specific to the TIC subpopulation that possessed critically short telomeres. In contrast, normal tissue stem cells had longer telomeres and undetectable telomerase activity and were insensitive to telomerase inhibition, which results in proliferation arrest, cell maturation, and DNA damage in neural TIC. Significant survival benefit and late tumor growth arrest of neuroblastoma TIC were observed in a xenograft model (P ¼ 0.02). Furthermore, neural TIC exhibited irreversible loss of self-renewal and stem cell capabilities even after cessation of treatment in vitro and in vivo.Conclusions: TIC exhaustion with telomerase inhibition and lack of telomerase dependency in normal stem cells add new dimensions to the telomere hypothesis and suggest that targeting TIC with telomerase inhibitors may represent a specific and safe therapeutic approach for tumors of neural origin.

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“…In the literature, pineal vanishing tumours do not show specific or recurrent histotypes, although, as expected, lymphomas are relatively frequently reported because of their trend to regress with corticosteroid therapy. 13,14 Furthermore, spontaneous regression of pediatric low grade astrocytomas, germinoma and pylocitic astrocytoma has also been reported. [12][13][14][15] Several hypotheses on the mechanism of spontaneous regression have been proposed, such as immunological responses, spontaneous apoptosis, hydration effects of cerebrospinal fluid drainage and effects of radiation by diagnostic X-ray, but they are still controversial.…”

Section: Discussionmentioning

confidence: 97%

“…13,14 Furthermore, spontaneous regression of pediatric low grade astrocytomas, germinoma and pylocitic astrocytoma has also been reported. [12][13][14][15] Several hypotheses on the mechanism of spontaneous regression have been proposed, such as immunological responses, spontaneous apoptosis, hydration effects of cerebrospinal fluid drainage and effects of radiation by diagnostic X-ray, but they are still controversial. 15 Interestingly, melatonin has showed oncostatic and immunomodulatory properties, which should be further investigated.…”

Section: Discussionmentioning

confidence: 97%

Vanishing pineal mass in a young patient without therapy: Case report and review of the literature

et al. 2016

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Spontaneous regression is defined as the decrease in size or disappearance of a primary tumour or metastatic disease without therapeutic intervention. Computed tomography and magnetic resonance imaging (MRI) of the brain was performed in a 14-year-old girl experiencing sudden-onset headaches. First diagnostic exams revealed a mass in the pineal region that disappeared at three-month MRI control. Three-year follow-up MRI studies were performed. No therapy was administered, but the pineal lesion had disappeared at three-year follow-up.

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Spontaneous regression of residual low-grade cerebellar pilocytic astrocytomas in children

Cited by 48 publications

References 31 publications

Frequent recurrence and progression in pilocytic astrocytoma in adults

Frequent recurrence and progression in pilocytic astrocytoma in adults

Neural Tumor-Initiating Cells Have Distinct Telomere Maintenance and Can be Safely Targeted for Telomerase Inhibition

Vanishing pineal mass in a young patient without therapy: Case report and review of the literature

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