Korean J Blood Transfus.  2007 Dec;18(3):227-238.

High Dose Chemotherapy and Autologous Peripheral Blood Stem Cell Transplantation in Pediatric Patients with High-risk Neuroblastoma

• Kim S
• Lee Y
• Lyu CJ
• Baek EJ
• Kim HS
• Lee K
• Kim HO

Abstract

BACKGROUND: High dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) has become standard therapy for high-risk neuroblastoma patients. We performed a retrospective analysis to assess the characteristics of peripheral blood stem cell harvest (PBSCH) and PBSCT and its clinical outcome.
METHODS
We reviewed 17 cases of patients with high-risk neuroblastoma that underwent PBSCH and/or high dose chemotherapy followed by PBSCT.
RESULTS
Sixteen patients had stage IV neuroblastoma and one patient had a stage III neuroblastoma with MYCN amplification. The median age of the 17 patients was 43 months (range 22~114 months) and the median body weight was 15 kg (range 10~24 kg). After induction chemotherapy using a modified N7 protocol, 34 PBSCHs (1.5 leukapheresis per PBSCH) were performed. A statistically significant correlation was found between the pre-leukapheresis CD34+ cell count and the total number CD34+ cells of the harvested products (P<0.0001). Tyrosine hydroxylase mRNA was not detected by RT-PCR in all of the leukapheresis products. High dose chemotherapy followed by PBSCT was performed in 24 cases. The mean infused CD34+ cell dose was 4.01x106/kg and WBC and platelet engraftment was performed on day 12.0 and 21.5, respectively. Eleven patients died, and six patients are surviving 11 to 68 months after PBSCT (median survival time, 35 months).
CONCLUSION
In this single institution study, treatment with high dose chemotherapy and PBSCT was performed successfully for children with high-risk neuroblastoma.

Keyword

High-risk neuroblastoma; Peripheral blood stem cell harvest; Peripheral blood stem cell transplantation

MeSH Terms

Blood Platelets
Body Weight
Cell Count
Child
Drug Therapy*
Humans
Induction Chemotherapy
Leukapheresis
Neuroblastoma*
Peripheral Blood Stem Cell Transplantation*
Retrospective Studies
RNA, Messenger
Stem Cells
Tyrosine 3-Monooxygenase
RNA, Messenger
Tyrosine 3-Monooxygenase