Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Young Children with Atypical Teratoid/Rhabdoid Tumor of the Central Nervous System.
10.3346/jkms.2012.27.2.135
- Author:
Eun Sil PARK
1
;
Ki Woong SUNG
;
Hee Jo BAEK
;
Kyung Duk PARK
;
Hyeon Jin PARK
;
Sung Chul WON
;
Do Hoon LIM
;
Heung Sik KIM
Author Information
1. Department of Pediatrics, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
- Publication Type:Original Article ; Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Rhabdoid Tumor;
Central Nervous System;
Drug Therapy;
Stem Cell Transplantation;
Radiotherapy;
Child
- MeSH:
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use;
Carboplatin/administration & dosage;
Central Nervous System Neoplasms/drug therapy/radiotherapy/*therapy;
Child, Preschool;
Combined Modality Therapy;
Cyclophosphamide/administration & dosage;
Etoposide/administration & dosage;
Female;
Follow-Up Studies;
Humans;
Induction Chemotherapy;
Infant;
Male;
Prospective Studies;
Recurrence;
Rhabdoid Tumor/drug therapy/radiotherapy/*therapy;
Salvage Therapy;
*Stem Cell Transplantation;
Survival Rate;
Thiotepa/administration & dosage;
Transplantation, Autologous
- From:Journal of Korean Medical Science
2012;27(2):135-140
- CountryRepublic of Korea
- Language:English
-
Abstract:
The feasibility and effectiveness of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) were evaluated in children younger than 3 yr of age with atypical teratoid/rhabdoid tumors (ATRT). Tandem HDCT/autoSCT was administered following six cycles of induction chemotherapy. Radiotherapy (RT) was administered if the tumor relapsed or progressed, otherwise, it was administered after 3 yr of age. Tumors relapsed or progressed during induction chemotherapy in 5 of 9 patients enrolled; 3 of these 5 received tandem HDCT/autoSCT as a salvage treatment. One patient died from sepsis during induction chemotherapy. The remaining 3 patients proceeded to tandem HDCT/autoSCT; however, 2 of these patients showed tumor relapse/progression after tandem HDCT/autoSCT. All 7 relapses/progressions occurred at primary sites even in patients with leptomeningeal seeding. Toxicities during tandem HDCT/autoSCT were manageable. A total of 5 patients were alive with a median follow-up of 20 (range 16-70) months from diagnosis. Four of 5 patients who received RT after relapse/progression are alive. The probability of overall survival at 3 yr from diagnosis was 53.3% +/- 17.3%. Our tandem HDCT/autoSCT is feasible; however, early administration of RT prior to tandem HDCT/autoSCT should be considered to improve the outcome after tandem HDCT/autoSCT.