Double High-dose Chemotherapy with Autologous Stem Cell Transplantation in Patients with High-risk Neuroblastoma: A Pilot Study in a Single Center.
10.3346/jkms.2002.17.4.537
- Author:
Ki Woong SUNG
1
;
Keon Hee YOO
;
Eun Hee CHUNG
;
Eun Joo CHO
;
Hye Lim JUNG
;
Hong Hoe KOO
;
Suk Koo LEE
;
Do Hoon LIM
;
Dae Yong KIM
;
Dae Won KIM
;
Hyung Rok KIM
;
Sun Woo KIM
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hhkoo@smc.samsung.co.kr
- Publication Type:Original Article ; Clinical Trial
- Keywords:
Neuroblastoma;
Drug Therapy;
Transplantation;
Autologous
- MeSH:
*Antineoplastic Combined Chemotherapy Protocols;
Child;
Child, Preschool;
Combined Modality Therapy;
Disease-Free Survival;
Female;
*Hematopoietic Stem Cell Transplantation;
Humans;
Infant;
Leukapheresis;
Male;
Neuroblastoma/drug therapy/pathology/*therapy;
Pilot Projects;
Remission Induction;
Risk Factors;
Transplantation, Autologous;
Treatment Outcome
- From:Journal of Korean Medical Science
2002;17(4):537-543
- CountryRepublic of Korea
- Language:English
-
Abstract:
Double high-dose chemotherapy (HDCT) was applied to 18 patients with highrisk neuroblastoma including 14 patients who could not achieve complete response (CR) even after the first HDCT. In 12 patients, successive double HDCT was rescued with peripheral blood stem cells collected during a single round of leukaphereses and in 6 patients, second or more rounds of leukaphereses were necessary after the first HDCT to rescue the second HDCT. The median interval between the first and second HDCT (76 days; range, 47-112) in the single harvest group was shorter than that (274.5 days; range, 83-329) in the double harvest group (p<0.01). Hematologic recovery was slow in the second HDCT. Six (33.3%) treatment-related mortalities (TRM) occurred during the second HDCT but were not related to the shorter interval. Disease-free survival rates at 2 years with a median follow-up of 24 months (range, 6-46) in the single and double harvest group were 57.1% and 33.3%, respectively. These results suggest that successive double HDCT using the single harvest approach may improve the survival of high-risk patients, especially who could not achieve CR after the first HDCT despite delayed hematologic recovery and high rate of TRM during the second HDCT.
