Effectiveness of autologous hematopoietic stem cell transplantation in the treatment of high-risk neuroblastoma in children: a single-center clinical study.
10.7499/j.issn.1008-8830.2301005
- Author:
Li-Hui WANG
1
;
Kai CHEN
1
;
Na ZHANG
1
;
Jing-Wei YANG
1
;
Ting ZHANG
1
;
Jing-Bo SHAO
1
Author Information
1. Department of Hematology/Oncology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200040, China.
- Publication Type:Journal Article
- Keywords:
Autologous hematopoietic stem cell transplantation;
Child;
Conditioning regimen;
Neuroblastoma;
Prognosis
- MeSH:
Child, Preschool;
Female;
Humans;
Male;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Bone Marrow Neoplasms/drug therapy*;
China;
Combined Modality Therapy;
Disease-Free Survival;
Hematopoietic Stem Cell Transplantation;
Neuroblastoma/pathology*;
Prognosis;
Retrospective Studies;
Stem Cell Transplantation;
Transplantation, Autologous
- From:
Chinese Journal of Contemporary Pediatrics
2023;25(5):476-482
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the effectiveness of high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation (ASCT) in the treatment of children with high-risk neuroblastoma (NB).
METHODS:A retrospective analysis was performed on 29 children with high-risk NB who were admitted to Shanghai Children's Hospital and were treated with high-dose chemotherapy combined with ASCT from January 2013 to December 2021, and their clinical features and prognosis were analyzed.
RESULTS:Among the 29 children treated by high-dose chemotherapy combined with ASCT, there were 18 boys (62%) and 11 girls (38%), with a median age of onset of 36 (27, 59) months. According to the International Neuroblastoma Staging System, 6 children (21%) had stage III NB and 23 children (79%) had stage IV NB, and the common metastatic sites at initial diagnosis were bone in 22 children (76%), bone marrow in 21 children (72%), and intracalvarium in 4 children (14%). All 29 children achieved reconstruction of hematopoietic function after ASCT. After being followed up for a median time of 25 (17, 45) months, 21 children (72%) had continuous complete remission and 8 (28%) experienced recurrence. The 3-year overall survival rate and event-free survival rate were 68.9%±16.1% and 61.4%±14.4%, respectively. Presence of bone marrow metastasis, neuron-specific enolase ≥370 ng/mL and positive bone marrow immunophenotyping might reduce the 3-year event-free survival rate (P<0.05).
CONCLUSIONS:Children with high-risk NB who have bone marrow metastasis at initial diagnosis tend to have a poor prognosis. ASCT combined with high-dose chemotherapy can effectively improve the prognosis of children with NB with a favorable safety profile.
