Clinical Significance of Persistent Tumor in Bone Marrow during Treatment of High-risk Neuroblastoma.
10.3346/jkms.2015.30.8.1062
- Author:
Young Bae CHOI
1
;
Go Eun BAE
;
Na Hee LEE
;
Jung Sun KIM
;
Soo Hyun LEE
;
Keon Hee YOO
;
Ki Woong SUNG
;
Hong Hoe KOO
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kwsped@skku.edu
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Neuroblastoma;
Bone Marrow Tumors;
Prognosis;
Treatment
- MeSH:
Adolescent;
Antineoplastic Combined Chemotherapy Protocols/administration & dosage;
Bone Marrow Neoplasms/pathology/*secondary/*therapy;
Child;
Child, Preschool;
Combined Modality Therapy/methods;
Female;
Humans;
Induction Chemotherapy/methods;
Infant;
Infant, Newborn;
Male;
Neoplasms, Multiple Primary/pathology/*therapy;
Neuroblastoma/*pathology/*therapy;
Prognosis;
Retrospective Studies;
Risk Factors;
Stem Cell Transplantation/*methods;
Treatment Outcome;
Young Adult
- From:Journal of Korean Medical Science
2015;30(8):1062-1067
- CountryRepublic of Korea
- Language:English
-
Abstract:
The records of 63 high-risk neuroblastoma patients with bone marrow (BM) tumors at diagnosis were retrospectively reviewed. All patients received nine cycles of induction chemotherapy followed by tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT). Follow-up BM examination was performed every three cycles during induction chemotherapy and every three months for one year after the second HDCT/auto-SCT. BM tumor cells persisted in 48.4%, 37.7%, 23.3%, and 20.4% of patients after three, six, and nine cycles of induction chemotherapy and three months after the second HDCT/auto-SCT, respectively. There was no difference in progression-free survival (PFS) rate between patients with persistent BM tumor and those without during the induction treatment. However, after tandem HDCT/auto-SCT, the PFS rate was worse in patients with persistent BM tumor than in those without (probability of 5-yr PFS 14.7% +/- 13.4% vs. 64.2% +/- 8.3%, P = 0.009). Persistent BM tumor during induction treatment is not associated with a worse prognosis when intensive tandem HDCT/auto-SCT is given as consolidation treatment. However, persistent BM tumor after tandem HDCT/auto-SCT is associated with a worse prognosis. Therefore, further treatment might be needed in patients with persistent BM tumor after tandem HDCT/auto-SCT.
