J Korean Med Sci.  2007 Sep;22(Suppl):S66-S72. 10.3346/jkms.2007.22.S.S66.

Retrospective Analysis of Peripheral Blood Stem Cell Transplantation for the Treatment of High-Risk Neuroblastoma

• Kim EK
• Kang HJ
• Park JA
• Choi HS
• Shin HY
• Ahn HS

• KMID: 1785791
• DOI: http://doi.org/10.3346/jkms.2007.22.S.S66

Abstract

Disease relapse after autologous peripheral blood stem cell transplantation (APBSCT) is the main cause of treatment failure in high-risk neuroblastoma (NBL). To reduce relapse, various efforts have been made such as CD34+ selection and double APBSCT. Here the authors reviewed the clinical features and outcomes of highrisk NBL patients and analyzed their survival. The medical records of 36 patients with stage III or IV NBL who underwent APBSCT at Seoul National University Children's Hospital between May 1996 and May 2004 were reviewed. Total 46 APBSCTs were performed in 36 patients. Disease free survival (DFS) and overall survival of all patients were 47.7% and 68.8%, respectively. The patients were allocated to three groups according to the APBSCT type. The DFS of CD34+ non-selected single APBSCT patients (N=13), CD34+ selected single APBSCT patients (N=14), and CD34+ selected double APBSCT patients (N=9) were 55.6%, 40.6%, and 50.0%, respectively, which were not significantly different. Thus the survival was not found to be affected by CD34+ selection or transplantation number. To improve long-term survival, various efforts should be made such as chemotherapy dose intensification, more effective tumor purging, and control of minimal residual disease via the use of differentiating and immune-modulating agents.

Keyword

Neuroblastoma; Peripheral Blood Stem Cell Transplantation; Autologous Transplantation

MeSH Terms

Antigens, CD34/metabolism
Child
Child, Preschool
Disease-Free Survival
Female
Hematopoietic Stem Cell Mobilization
Humans
Infant
Korea/epidemiology
Male
Neuroblastoma/mortality/*therapy
Peripheral Blood Stem Cell Transplantation/adverse effects/mortality
Prognosis
Retrospective Studies
Survival Rate
Transplantation Conditioning
Transplantation, Autologous

Figure

• 

  Fig. 1 Kaplan-Meier probabilities of DFS and OS for high-risk neuroblastoma patients after APBSCT (N=36). DFS was 47.7±9.6% and OS 68.8±9.1%. Ticks indicate censored data. DFS, disease-free survival; OS, overall survival; APBSCT, autologous peripheral blood stem cell transplantation; PBSCT, peripheral blood stem cell transplantation.

• 

  Fig. 2 DFSs of patients according to (A) the type of APBSCT and (B) CD34+ selection. Survival curves indicated no statistical differences between the various groups. Ticks indicate censored data. DFS, disease-free survival; APBSCT, autologous peripheral blood stem cell transplantation; PBSCT, peripheral blood stem cell transplantation.

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