Document 2888
 DOCN  M94A2888
 TI    Treatment of AIDS and progressive multifocal leucoencephalopathy (PML)
       with cytarabine when the brain biopsy is unsuccessful or impossible.
 DT    9412
 AU    Ravaux I; Quinson AM; North MO; Gallais H; Infectious Diseases Unit,
       Hopital La Conception, Marseille,; France.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):201 (abstract no. PB0231). Unique
       Identifier : AIDSLINE ICA10/94369687
 AB    OBJECTIVE: Is it justified to propose a treatment with CYTARABINE IV
       when the diagnosis is only strongly presumed on clinical courses. CT
       scanner and IRM, therapeutic criteria and responsiveness to a three
       weeks course of antitoxoplasma therapy. OUR EXPERIENCE: We have studied
       12 AIDS patients, 7 women and 5 men, from 25 to 45 years old, with CD4
       count inferior to 200/mm3. 11 of them used AZT (500 mg/j). CLINICAL
       PRESENTATION: Headache, disorders of cognitive functions with or without
       focal signs. The assay of antitoxoplasma therapy failed. The white
       matter was affected exclusively by multiple lesions or a single large
       lesion: showing homogeneously hypodense areas at CT and low density (T1)
       or high signal intensity areas. Predominated at the cortical subcortical
       junction. Without diffuse and symmetrical involvement of the white
       matter, no mass effect. For 4 patients specific JC virus DNA
       amplification by PCR in CSF was used with positive results. All of them
       have received IV CYTARABINE HYPOCHLORIDE therapy. RESULTS: After 9
       months of treatment including 6 sequences of therapy, one patient is
       alive and his clinical state is really ameliorated: but 5 died before 3
       months, for the others, after stabilisation during 5 months, they also
       died of opportunistic infections. DISCUSSION: So, in front of clinical
       and radiological signs of PML we think that CYTARABINE IV could be
       proposed, even if the diagnosis is not histologically confirmed.
 DE    Adult  AIDS-Related Opportunistic Infections/DIAGNOSIS/*DRUG THERAPY
       Biopsy  Brain/PATHOLOGY  Cytarabine/*THERAPEUTIC USE  Female  Human
       Leukoencephalopathy, Progressive Multifocal/DIAGNOSIS/*DRUG  THERAPY
       Male  Middle Age  MEETING ABSTRACT

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