CNS 18 - 13 
tapered according to individual patient requirement. As experience is 
gained, the need for high dose dexamethasone may be modified. 
5.2.3 Mannitol : 1 g/kg will be given during surgery and every 8 hours for a 
total of 24 hours following the procedure. 
5.2.4 Anticonvulsants: Anticonvulsive therapy will be administered according 
to the usual neurosurgical guidelines for such medications. 
5.2.5 Analgesics ; Pain medications will include Acetaminophen 5-10 
mg/kg/dose q4 hours (max dose 1000 mg QID). 
5.3 Ganciclovir Sodium Administration 
On day til following instillation of producer-vector cells, GCV will be 
administered by intravenous infusion over one hour . A dose of 5 mg/kg of body 
weight is to be given twice daily (10 mg/kg/day total dose) for 14 consecutive 
days. Ganciclovir is reconstituted with sterile water and diluted with normal 
saline to a final concentration of 10 mg/ml. 
5.3.1 GCV Dose Interruption for Toxicity 
A total of 14 days of ganciclovir is to be given; if therapy is delayed (see 
below), more than 14 days may be needed to deliver all 14 scheduled 
doses. Do not omit doses. 
5.3. 1.1 Hematologic 
The development of an ANC of <500 cells/mm 3 or a 
platelet count of < 25,000/mm 3 require dose interruptions 
until the ANC is >.750 cells/mm 3 and platelet count is 
>.40,000 platelets/mm 3 . Call study Principal investigator 
if hematologic toxicity persists > 3 days. 
5.3. 1.2 Renal 
Renal toxicity has primarily been reversible increase in 
serum creatinine levels. No dose modifications will be 
made for serum creatinine level below 2.5 x N. If the 
serum creatinine increase is greater than 2.5 x N for age, 
delay further GCV until creatinine level has fallen to less 
than 1.5 N for age. Call study Principal investigator if 
renal toxicity persists greater than 3 days. 
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