Study of the Effect of GM-CSF on Macrophages in Ependymoma

Inclusion Criteria

• •Age \> 12 months and \< 21 years at the time of study enrollment.
• •Patients must be one of the following:
• •• Newly diagnosed with posterior fossa ependymoma with a subtotal resection at initial surgery. These patients will be eligible for stratum 1.
• •* Be in first relapse of their posterior fossa ependymoma. These patients will be eligible for stratum 2.
• •Histologically confirmed diagnosis of intracranial ependymoma .
• •Pre or post-operative MR imaging of the brain demonstrates no evidence of non-contiguous spread beyond the primary site
• •Pre or post-operative MR imaging of the spine demonstrates no evidence of non-contiguous spread beyond the primary site
• •Pre-operative CSF cytology obtained from the lumbar CSF space demonstrated no evidence of non-contiguous spread beyond the primary site.
• •• The requirement for lumbar CSF examination may be waived if deemed to be medically contraindicated.
• •Patients must meet one of the following performance scores.
• •• ECOG performance status scores of 0, 1, or 2.
• •* Karnofsky score of ≥ 50 for patients \> 16 years of age or Lansky score of ≥ 50 for patients ≤ 16 years of age
• •Organ Function Requirements:
• •Adequate renal function defined as:
• •Creatinine clearance or radioisotope GFR ³ 70ml/min/1.73 m2 or
• •A serum creatinine based on age/gender as follows:
• •Age Maximum Serum Creatinine (mg/dL) Male Female
• •1 month to \< 6 months 0.4 0.4 6 months to \< 1 year 0.5 0.5
• •1 to \< 2 years 0.6 0.6 2 to \< 6 years 0.8 0.8 6 to \< 10 years 1 1 10 to \< 13 years 1.2 1.2 13 to \< 16 years 1.5 1.4
• •≥ 16 years 1.7 1.4 The threshold creatinine values in this Table were derived from the Schwartz formula for estimating GFR (Schwartz et al. J. Peds, 106:522, 1985) utilizing child length and stature data published by the CDC.
• •Adequate liver function defined as:
• •Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age, and
• •SGOT (AST) or SGPT (ALT) \< 3 x upper limit of normal (ULN) for age.
• •Adequate Bone Marrow Function defined as:
• •Peripheral absolute neutrophil count (ANC) \>= 1,000/uL
• •Platelet count \>= 100,000/uL (transfusion independent).