High-dose Chemotherapy and Autologous Stem Cell Rescue in Patients with High-risk Stage 3 Neuroblastoma: 10-Year Experience at a Single Center.
10.3346/jkms.2009.24.4.660
- Author:
Jung Min SUH
1
;
Keon Hee YOO
;
Ki Woong SUNG
;
Ju Youn KIM
;
Eun Joo CHO
;
Hong Hoe KOO
;
Suk Koo LEE
;
Jhingook KIM
;
Do Hoon LIM
;
Yeon Lim SUH
;
Dae Won KIM
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kwsped@skku.edu
- Publication Type:Case Reports
- Keywords:
Neuroblastoma;
High-dose Chemotherapy;
Autologous Stem Cell Rescue;
Prognosis;
N-myc
- MeSH:
Adolescent;
Adult;
Child;
Combined Modality Therapy;
Female;
Granulocyte Colony Stimulating Factor, Recombinant/therapeutic use;
Humans;
Male;
Middle Aged;
Neoplasm Staging;
Neuroblastoma/drug therapy/mortality/*therapy;
*Peripheral Blood Stem Cell Transplantation;
Proto-Oncogene Proteins c-myc/analysis/genetics;
Survival Rate;
Tomography, X-Ray Computed;
Transplantation, Autologous
- From:Journal of Korean Medical Science
2009;24(4):660-667
- CountryRepublic of Korea
- Language:English
-
Abstract:
High-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was applied to improve the prognosis of patients with high-risk stage 3 neuroblastoma. From January 1997 to December 2006, 28 patients were newly diagnosed as stage 3 neuroblastoma. Nine of 11 patients with N-myc amplification and 5 of 17 patients without N-myc amplification (poor response in 2 patients, persistent residual tumor in 2 and relapse in 1) underwent single or tandem HDCT/ASCR. Patients without high-risk features received conventional treatment modalities only. While 8 of 9 patients underwent single HDCT/ASCR and the remaining one patient underwent tandem HDCT/ASCR during the early study period, all 5 patients underwent tandem HDCT/ASCR during the late period. Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality. While the tumor relapsed in two of eight patients in single HDCT/ASCR group, all six patients in tandem HDCT/ASCR group remained relapse free. The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%. In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR. The present study demonstrates that HDCT/ASCR may improve the survival of patients with high-risk stage 3 neuroblastoma.
