High‐dose chemotherapy and autologous stem cell rescue in children with newly diagnosed high‐risk or relapsed medulloblastoma or supratentorial primitive neuroectodermal tumor
- 21 February 2007
- journal article
- clinical trial
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 48 (4), 408-415
- https://doi.org/10.1002/pbc.21064
Abstract
Background Single or tandem double high‐dose chemotherapy (HDCT) was used to treat children with newly diagnosed high‐risk or relapsed medulloblastoma and supratentorial primitive neuroectodermal tumor (MB/sPNET) in order to defer or avoid radiotherapy in young children. Procedure Thirty‐seven HDCTs were given to 25 children with newly diagnosed high‐risk or relapsed MB/sPNET. Tandem double HDCT was used for 12 of 15 patients initially intended to receive double HDCT. Results Three‐year EFS (±SE) in 6 newly diagnosed high‐risk (>3 years old), 8 newly diagnosed (P = 0.001). Three‐year EFS in patients initially intended to receive double HDCT and single HDCT was 66.0 ± 12.4% and 40.0 ± 15.5%, respectively. For 19 patients in CR or PR at first HDCT, 3‐year EFS was 88.9 ± 10.5% in tandem double HDCT group, and 44.4 ± 16.6% in single HDCT group, respectively (P = 0.037). Although four treatment‐related mortalities (TRMs) occurred during 25 first HDCTs, no TRM occurred during 12 second HDCTs. In four of eight young children, craniospinal radiotherapy was successfully withheld without subsequent relapse. Conclusions High‐dose chemotherapy may improve the survival of children with newly diagnosed high‐risk MB/sPNET, and, to some extent, the survival of those with relapsed MB/sPNET. Further study is necessary to elucidate the efficacy of tandem double HDCT. Pediatr Blood CancerThis publication has 26 references indexed in Scilit:
- Treatment of Early Childhood Medulloblastoma by Postoperative Chemotherapy AloneThe New England Journal of Medicine, 2005
- Evolving role of myeloablative chemotherapy in the treatment of childhood brain tumoursBone Marrow Transplantation, 2005
- Feasibility and Response to Induction Chemotherapy Intensified With High-Dose Methotrexate for Young Children With Newly Diagnosed High-Risk Disseminated MedulloblastomaJournal of Clinical Oncology, 2004
- Application of stem cell transplant for brain tumorsPediatric Transplantation, 2004
- High‐dose chemotherapy with autologous stem‐cell rescue in the treatment of patients with recurrent non‐cerebellar primitive neuroectodermal tumorsPediatric Blood & Cancer, 2003
- Successive double high-dose chemotherapy with peripheral blood stem cell rescue collected during a single leukapheresis round in patients with high-risk pediatric solid tumors: a pilot study in a single centerBone Marrow Transplantation, 2003
- Supratentorial embryonal tumors in children under 5 years of age: An SFOP study of treatment with postoperative chemotherapy aloneMedical and Pediatric Oncology, 2002
- Will high dose chemotherapy followed by autologous bone marrow transplantation supplant cranio-spinal irradiation in young children treated for medulloblastoma?Journal of Neuro-Oncology, 1996
- Surveillance Scanning of Children with MedulloblastomaThe New England Journal of Medicine, 1994
- Medulloblastoma: freedom from relapse longer than 8 years — a therapeutic cure?Journal of Neurosurgery, 1991