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Gleolan (aminolevulinic acid hydrochloride, ALA HCI), also referred to as 5-ALA, is one of the newest tools approved for use in glioma surgery. It’s an optical imaging agent that highlights tumor cells, making them easier for surgeons to see during resection surgery. Even with the most modern technology, it is often difficult for surgeons to determine if they have removed all of the tumor, especially with gliomas, which tend to have “finger-like” projections that extend into different parts of the brain. The 5-ALA dye makes those tiny projections more visible.
Henry Ford was instrumental in getting 5-ALA approved for use, by participating in the clinical trial that led to its FDA approval in June 2017. It’s expected to be available to patients soon and Henry Ford will be one of the only area health systems to offer it
5-ALA is a dye that patients drink a few hours before surgery. The compound turns the harmful tumor cells bright pink or magenta, making them more visible under a special blue light, allowing for a more complete resection.
In the initial randomized, controlled clinical trial performed in the U.S., patients who were given 5-ALA before surgery had twice the rate of survival without progression after six months, compared to patients who didn’t receive the dye.
The most commonly reported side effects of 5-ALA are minor to moderate gastrointestinal discomfort and sensitivity to light. Patients who elect to use 5-ALA must remain in a dark environment for 48-72 hours following surgery to protect against temporary skin damage that could occur, similar to a sunburn.