J Korean Med Sci.
2002 Aug;17(4):537-543. 10.3346/jkms.2002.17.4.537.
Double High-dose Chemotherapy with Autologous Stem Cell Transplantation in Patients with High-risk Neuroblastoma: A Pilot Study in a Single Center
- Affiliations
-
- 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hhkoo@smc.samsung.co.kr
- 2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3Department of Clinical Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 5Biostatistics Unit, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- KMID: 1109765
- DOI: http://doi.org/10.3346/jkms.2002.17.4.537
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.
Keyword
MeSH Terms
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*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
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