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High-dose chemotherapy and autologous stem cell rescue in patients with high-risk stage 3 neuroblastoma: 10-year experience at a single center.

Suh JM, Yoo KH, Sung KW, Kim JY, Cho EJ, Koo HH, Lee SK, Kim J, Lim do H, Suh YL, Kim DW - J. Korean Med. Sci. (2009)

Bottom Line: Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality.The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%.In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
High-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was applied to improve the prognosis of patients with high-risk stage 3 neuroblastoma. From January 1997 to December 2006, 28 patients were newly diagnosed as stage 3 neuroblastoma. Nine of 11 patients with N-myc amplification and 5 of 17 patients without N-myc amplification (poor response in 2 patients, persistent residual tumor in 2 and relapse in 1) underwent single or tandem HDCT/ASCR. Patients without high-risk features received conventional treatment modalities only. While 8 of 9 patients underwent single HDCT/ASCR and the remaining one patient underwent tandem HDCT/ASCR during the early study period, all 5 patients underwent tandem HDCT/ASCR during the late period. Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality. While the tumor relapsed in two of eight patients in single HDCT/ASCR group, all six patients in tandem HDCT/ASCR group remained relapse free. The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%. In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR. The present study demonstrates that HDCT/ASCR may improve the survival of patients with high-risk stage 3 neuroblastoma.

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Related in: MedlinePlus

Flow of the patients from diagnosis through HDCT/ASCR. All except two patients with N-myc amplification (early death in 1 and refusal to receive HDCT in 1) underwent HDCT/ASCR. In addition, 5 of 17 patients without N-myc amplification (poor response to chemotherapy in 2 patients, persistent gross residual tumor in 2 patients and relapse during chemotherapy in 1 patient) underwent HDCT/ASCR. Therefore, overall 14 patients underwent HDCT/ASCR. Eleven of 17 patients without N-myc amplification received conventional chemotherapy alone.
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Figure 1: Flow of the patients from diagnosis through HDCT/ASCR. All except two patients with N-myc amplification (early death in 1 and refusal to receive HDCT in 1) underwent HDCT/ASCR. In addition, 5 of 17 patients without N-myc amplification (poor response to chemotherapy in 2 patients, persistent gross residual tumor in 2 patients and relapse during chemotherapy in 1 patient) underwent HDCT/ASCR. Therefore, overall 14 patients underwent HDCT/ASCR. Eleven of 17 patients without N-myc amplification received conventional chemotherapy alone.

Mentions: Fig. 1 summarizes the treatment. Most patients received 5-6 cycles of chemotherapy before definitive surgery, except for those patients that had a surgical resection before the administration of chemotherapy. If it was difficult to debulk the tumor, an additional 1-2 cycles of chemotherapy were given prior to the definitive surgery.


High-dose chemotherapy and autologous stem cell rescue in patients with high-risk stage 3 neuroblastoma: 10-year experience at a single center.

Suh JM, Yoo KH, Sung KW, Kim JY, Cho EJ, Koo HH, Lee SK, Kim J, Lim do H, Suh YL, Kim DW - J. Korean Med. Sci. (2009)

Flow of the patients from diagnosis through HDCT/ASCR. All except two patients with N-myc amplification (early death in 1 and refusal to receive HDCT in 1) underwent HDCT/ASCR. In addition, 5 of 17 patients without N-myc amplification (poor response to chemotherapy in 2 patients, persistent gross residual tumor in 2 patients and relapse during chemotherapy in 1 patient) underwent HDCT/ASCR. Therefore, overall 14 patients underwent HDCT/ASCR. Eleven of 17 patients without N-myc amplification received conventional chemotherapy alone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2719186&req=5

Figure 1: Flow of the patients from diagnosis through HDCT/ASCR. All except two patients with N-myc amplification (early death in 1 and refusal to receive HDCT in 1) underwent HDCT/ASCR. In addition, 5 of 17 patients without N-myc amplification (poor response to chemotherapy in 2 patients, persistent gross residual tumor in 2 patients and relapse during chemotherapy in 1 patient) underwent HDCT/ASCR. Therefore, overall 14 patients underwent HDCT/ASCR. Eleven of 17 patients without N-myc amplification received conventional chemotherapy alone.
Mentions: Fig. 1 summarizes the treatment. Most patients received 5-6 cycles of chemotherapy before definitive surgery, except for those patients that had a surgical resection before the administration of chemotherapy. If it was difficult to debulk the tumor, an additional 1-2 cycles of chemotherapy were given prior to the definitive surgery.

Bottom Line: Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality.The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%.In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
High-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was applied to improve the prognosis of patients with high-risk stage 3 neuroblastoma. From January 1997 to December 2006, 28 patients were newly diagnosed as stage 3 neuroblastoma. Nine of 11 patients with N-myc amplification and 5 of 17 patients without N-myc amplification (poor response in 2 patients, persistent residual tumor in 2 and relapse in 1) underwent single or tandem HDCT/ASCR. Patients without high-risk features received conventional treatment modalities only. While 8 of 9 patients underwent single HDCT/ASCR and the remaining one patient underwent tandem HDCT/ASCR during the early study period, all 5 patients underwent tandem HDCT/ASCR during the late period. Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality. While the tumor relapsed in two of eight patients in single HDCT/ASCR group, all six patients in tandem HDCT/ASCR group remained relapse free. The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%. In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR. The present study demonstrates that HDCT/ASCR may improve the survival of patients with high-risk stage 3 neuroblastoma.

Show MeSH
Related in: MedlinePlus