High Dose Chemotherapy with Autologous Peripheral Blood Stem Cell Transplantation in Patients with Medulloblastoma/Primitive Neuroectodermal Tumor.
- Author:
Ki Woong SUNG
1
;
Keon Hee YOO
;
Hong Hoe KOO
;
Do Hoon LIM
;
Hyung Jin SHIN
;
Yoon Jeong KIM
;
Seung Do AHN
;
Young Shin RA
;
Thad T GHIM
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Medulloblastoma;
PNET;
High dose chemotherapy;
Peripheral blood stem cell transplantation
- MeSH:
Blood Platelets;
Carboplatin;
Cyclophosphamide;
Disease-Free Survival;
Drug Therapy*;
Etoposide;
Follow-Up Studies;
Granulocytes;
Humans;
Immunotherapy;
Interleukin-2;
Leukapheresis;
Medulloblastoma;
Melphalan;
Neural Plate*;
Neuroectodermal Tumors*;
Neuroectodermal Tumors, Primitive;
Peripheral Blood Stem Cell Transplantation*;
Prognosis;
Radiotherapy;
Sepsis;
Stem Cells;
Thiotepa
- From:Korean Journal of Pediatric Hematology-Oncology
2001;8(2):264-272
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To improve survival and/or to avoid radiotherapy, high dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (PBSCT) was given to patients with recurrent or high risk medulloblastoma (MB)/primitive neuroectodermal tumor (PNET) as well as patients younger than 3 years of age. METHODS: Six patients (3 recurrent, 1 high risk, 2 younger than 3 years; 5 MBs and 1 PNET) received single or double HDCT and PBSCT with or without immunotherapy using interleukin-2. Chemotherapeutic regimen in the first HDCT included cyclophosphamide (1,500 mg/m2/ day for 4 days) and melphalan (60 mg/m2/day for 3 days). Chemotherapeutic regimen in the second HDCT included carboplatin (400 mg/m2/day for 3 days), thiotepa (250 mg/ m2/day for 3 days), and etoposide (200 mg/m2/day for 3 days). RESULTS: Nine HDCTs were applied in 6 patients. Three double HDCTs were rescued with peripheral blood stem cells collected during single round leukapheresis. Rapid hematologic recovery occurred in 4 patients. Engraft failure occurred in 1 patient and delayed granulocyte recovery and platelet engraft failure occurred in 1 patient. Three patients who had minimal disease before HDCT had event free survival for 7~18 months after HDCT. Tumor relapsed 8 and 12 months after single HDCT in 2 patients among 3 patients with recurrent MB/PNET. One patient with recurrent MB died due to engraft failure and sepsis. CONCLUSION: HDCT with autologous PBSCT is expected to improve survival of patients with poor prognosis MB/PNET including younger patients less than 3 years. Subsequent trials with larger number of patients and long-term follow-up are needed.
