Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for High-Grade Gliomas in Children and Adolescents.
10.3346/jkms.2017.32.2.195
- Author:
Ji Won LEE
1
;
Do Hoon LIM
;
Ki Woong SUNG
;
Hyeong Jin LEE
;
Eun Sang YI
;
Keon Hee YOO
;
Hong Hoe KOO
;
Yeon Lim SUH
;
Hyung Jin SHIN
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
High-grade Glioma;
Brain Tumor;
High-dose Chemotherapy;
Autologous Stem Cell Transplantation;
Children
- MeSH:
Adolescent*;
Astrocytoma;
Brain Neoplasms;
Carboplatin;
Child*;
Cyclophosphamide;
Drug Therapy*;
Etoposide;
Glioblastoma;
Glioma*;
Hepatic Veno-Occlusive Disease;
Humans;
Medical Records;
Melphalan;
Radiotherapy;
Retrospective Studies;
Stem Cell Transplantation*;
Stem Cells*;
Thiotepa
- From:Journal of Korean Medical Science
2017;32(2):195-203
- CountryRepublic of Korea
- Language:English
-
Abstract:
With the aim to investigate the outcome of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) for high-grade gliomas (HGGs), we retrospectively reviewed the medical records of 30 patients with HGGs (16 glioblastomas, 7 anaplastic astrocytomas, and 7 other HGGs) between 2006 and 2015. Gross or near total resection was possible in 11 patients. Front-line treatment after surgery was radiotherapy (RT) in 14 patients and chemotherapy in the remaining 16 patients including 3 patients less than 3 years of age. Eight of 12 patients who remained progression free and 5 of the remaining 18 patients who experienced progression during induction treatment underwent the first HDCT/auto-SCT with carboplatin + thiotepa + etoposide (CTE) regimen and 11 of them proceeded to the second HDCT/auto-SCT with cyclophosphamide + melphalan (CyM) regimen. One patient died from hepatic veno-occlusive disease (VOD) during the second HDCT/auto-SCT; otherwise, toxicities were manageable. Four patients in complete response (CR) and 3 of 7 patients in partial response (PR) or second PR at the first HDCT/auto-SCT remained event free: however, 2 patients with progressive tumor experienced progression again. The probabilities of 3-year overall survival (OS) after the first HDCT/auto-SCT in 11 patients in CR, PR, or second PR was 58.2% ± 16.9%. Tumor status at the first HDCT/auto-SCT was the only significant factor for outcome after HDCT/auto-SCT. There was no difference in survival between glioblastoma and other HGGs. This study suggests that the outcome of HGGs in children and adolescents after HDCT/auto-SCT is encouraging if the patient could achieve CR or PR before HDCT/auto-SCT.
