Clin Pediatr Hematol Oncol.  2006 Apr;13(1):9-21.

Improved Survival in Neuroblastoma by Autologous Peripheral Blood Stem Cell Transplantation: A Single Institution Experience

• Kim JY
• Baek HJ
• Han DK
• Sung JS
• Nam TK
• Yoon MS
• Kook H
• Hwang TJ

Abstract

PURPOSE: Neuroblastoma is the most common extracranial solid tumor of childhood, and its outcome in advanced diseases has been very poor. We evaluated the treatment outcome and prognostic factors in advanced neuroblastoma.
METHODS
A retrospective review of 48 patients with neuroblastoma at Chonnam National University Hospital was undertaken. The conventional treatment was given to Stage 1, 2, 3 patients. For Stage 4 and relapsed patients, high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT) was administered. All patients who completed the cytotoxic therapy then either received no further therapy or were treated with 13-cis-retinoic acid (CRA) for six months.
RESULTS
Most of the patients were in advanced stages: 11 in stage III and 26 in stage IV. Autologous PBSCT was done in 14 cases. The 5-year event-free survival (EFS) was 41% in all patients with 100% for Stage 1, 67% for Stage 2/3, 35% for stage 4, 50% of 4S. In cases of stage 4 neuroblastoma, the EFS rate at 4 years after diagnosis was better in the autologous PBSCT group than in chemotherapy group (51% vs. 20%; P=.05). Also, the EFS was better in patients who received 13-CRA after PBSCT than those who did not (100% vs. 14%; P<.005).
CONCLUSION
Treatment with high dose chemotherapy and autologous PBSCT improved the EFS among children with advanced neuroblastoma. In addition, treatment with 13-CRA was beneficial for patients who underwent transplantation. Prospective randomized study is warranted to further improve survival for the subset of advanced patients who might fail to current management strategies.

Keyword

Neuroblastoma; Autologous peripheral blood stem cell transplantation; 13-cis-retinoic acid

MeSH Terms

Child
Diagnosis
Disease-Free Survival
Drug Therapy
Humans
Isotretinoin
Jeollanam-do
Neuroblastoma*
Peripheral Blood Stem Cell Transplantation*
Retrospective Studies
Treatment Outcome
Isotretinoin