state of health and prior therapies. The blood tests will also include 
a test for the HIV (AIDS) virus. Women of child bearing age will also 
have a pregnancy test. Children with HIV and pregnant women will not 
be eligible for this protocol. (You will be required to sign a separate 
consent form for the HIV blood test.) 
An MR scan and/or a CT scan of your child's brain will be done. 
Both scans are designed to examine the changes in the nervous system 
that occur with the recurrence of the brain tumor. MR uses a strong 
magnetic field and radio waves to show structural and chemical changes 
in the brain tissues. A CT scan uses X-rays. The type of scan chosen 
will depend upon the status of the tumor and the response to this 
therapy. During the scan, a needle will be placed into a vein in your 
child's arm and an image-enhancing dye may be administered through that 
vein before obtaining a second set of scans. Each scan takes about 60- 
90 minutes. Scans will be repeated periodically after injection of the 
vector-producing cells to monitor the effect of this therapy on tumor 
growth. 
If the size and location of your child's tumor are such that 
partial surgical removal is possible, he/she will undergo three 
procedures in the following order: 1. Brain surgery to remove as much 
of the tumor as possible with injection of vector-producing cells into 
areas of the remaining tumor. An Ommaya reservoir will be placed under 
the scalp with a tube connecting the reservoir to the tumor site. The 
reservoir allows for the repeated injection of vector-producing cells 
without repeated surgery on the brain. 2. One week after surgery, an 
injection of additional vector-producer cells through the Ommaya 
reservoir into the tumor cavity. 3. Twice daily intravenous injections 
of Cytovene for 14 days beginning two weeks after the initial surgery. 
Surgery: 
Your child will be taken to the operating room and, following 
administration of general anesthesia, a craniotomy (direct surgery on 
the brain) will be performed. A piece of skull will be removed, the 
coverings of the brain will be opened and as much tumor will be removed 
as possible. Since it is impossible to completely remove a recurrent 
brain tumor surgically, the remaining tumor will be injected with the 
vector-producing cells during the operation. Following surgery, your 
child will be monitored in the intensive care unit (ICU) . During the 
various stages of therapy, your child may receive various drugs to 
prevent convulsions and swelling within the brain. These drugs are used 
routinely in neurosurgery. 
Injection of vectdr-producing cells through the Ommaya reservoir: 
Seven days after surgery, additional vector-producing cells will 
be injected into the area of the remaining tumor. This will be 
performed in the clinic by the neurosurgery staff. There is no need for 
anesthesia . 
Cytovene administration: 
Fourteen days after surgery, Cytovene infusions will be started. 
Cytovene will be administered into a vein by slow drip lasting about one 
hour. The drug will be given two times a day for 14 days. Your child 
may have an MR or CT scan before, during and after Cytovene therapy. 
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Recombinant DNA Research, Volume 18 
