Treatment of malignant glioma with high dose intra-arterial ACNU and autologous bone marrow transplantation--case report.

A 44-year-old female with malignant astrocytoma received subtotal removal and high dose (200 mg/m2) intra-arterial 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2- chloroethyl)-3-nitrosourea hydrochloride (ACNU) with autologous bone marrow transplantation. Tumor remission with minimal bone marrow suppression was achieved. However, she developed severe encephalopathy and computed tomographic scans revealed a low-density area at the ACNU delivery site. She received glycerol solution to treat the brain edema and recovered completely from the encephalopathy. Intra-arterial ACNU exceeding 200 mg/m2 possibly causes neurotoxicity.