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Efficacy of high-dose chemotherapy and autologous stem cell transplantation in patients with relapsed medulloblastoma: a report on the Korean Society for Pediatric Neuro-Oncology (KSPNO)-S-053 study.

Park JE, Kang J, Yoo KH, Sung KW, Koo HH, Lim do H, Shin HJ, Kang HJ, Park KD, Shin HY, Kim IH, Cho BK, Im HJ, Seo JJ, Park HJ, Park BK, Ahn HS - J. Korean Med. Sci. (2010)

Bottom Line: The 3-yr overall survival probability and event-free survival rates +/-95% confidence intervals (CI) were 33.3+/-12.2% and 26.7% +/-11.4%, respectively.When analysis was confined to only patients who had a complete response (CR) or partial response (PR) prior to HDCT, the probability of 3-yr overall survival rates +/-95% CI was 40.0+/-15.5%.No patients with stable disease (SD) or progressive disease (PD) survived.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT
The efficacy and toxicity of high-dose chemotherapy and autologous stem cell transplantation (HDCT/ASCT) were investigated for improving the outcomes of patients with relapsed medulloblastoma. A total of 15 patients with relapsed medulloblastoma were enrolled in the KSPNO-S-053 study from May 2005 to May 2007. All patients received approximately 4 cycles of salvage chemotherapy after relapse. Thirteen underwent HDCT/ASCT; CTE and CM regimen were employed for the first HDCT (HDCT1) and second HDCT (HDCT2), respectively, and 7 underwent HDCT2. One transplant related mortality (TRM) due to veno-occlusive disease (VOD) occurred during HDCT1 but HDCT2 was tolerable with no further TRM. The 3-yr overall survival probability and event-free survival rates +/-95% confidence intervals (CI) were 33.3+/-12.2% and 26.7% +/-11.4%, respectively. When analysis was confined to only patients who had a complete response (CR) or partial response (PR) prior to HDCT, the probability of 3-yr overall survival rates +/-95% CI was 40.0+/-15.5%. No patients with stable disease (SD) or progressive disease (PD) survived. Survival rates from protocol KSPNO-S-053 are encouraging and show that tumor status prior to HDCT/ASCT is an important factor to consider for improving survival rates of patients with relapsed medulloblastoma.

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Related in: MedlinePlus

(A) Event free and overall survival of all patients at 3 year survival from diagnosis of relapsed tumor (n=15). (B) Event free and overall survival of the patients who received HDCT from when diagnosis of relapsed tumor (n=13). (C) Overall survival of the patients who received HDCT in pre-HDCT CR or PR status vs. SD or PD status from 1st HDCT (n=10).
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Figure 2: (A) Event free and overall survival of all patients at 3 year survival from diagnosis of relapsed tumor (n=15). (B) Event free and overall survival of the patients who received HDCT from when diagnosis of relapsed tumor (n=13). (C) Overall survival of the patients who received HDCT in pre-HDCT CR or PR status vs. SD or PD status from 1st HDCT (n=10).

Mentions: Three year OS and EFS rates of the total 15 patients from the time of relapse, were 33.3±12.2% and 26.7±11.4%, respectively (Fig. 2A). Of the 15 patients, 2 could not received HDCT(s) because 1 patient had rapidly progressive disease without preparing to do HDCT, and another patient died of sepsis during the period of SC. The 3-yr OS rate of the 13 patients who underwent HDCT(s) was 28.8±13.1% with a median follow-up of 21 months (range 9-44) after diagnosis of tumor relapse. Four patients are alive and event-free at 35, 38, 39 and 44 months since diagnosis of a relapsed tumor. Of 9 patients who had events, 8 experienced relapse or progression since HDCT1, and another had TRM at the time of HDCT1 and ASCT. Three-year EFS rates for these patients was 30.8±12.8% with a median follow-up of 16 months (range 7-44) after the diagnosis of relapsed tumor (Fig. 2B). There were no statistical differences in survival rates between the 2 groups of patients who received tandem (7 patients) or single (8 patients) transplantation (data not shown).


Efficacy of high-dose chemotherapy and autologous stem cell transplantation in patients with relapsed medulloblastoma: a report on the Korean Society for Pediatric Neuro-Oncology (KSPNO)-S-053 study.

Park JE, Kang J, Yoo KH, Sung KW, Koo HH, Lim do H, Shin HJ, Kang HJ, Park KD, Shin HY, Kim IH, Cho BK, Im HJ, Seo JJ, Park HJ, Park BK, Ahn HS - J. Korean Med. Sci. (2010)

(A) Event free and overall survival of all patients at 3 year survival from diagnosis of relapsed tumor (n=15). (B) Event free and overall survival of the patients who received HDCT from when diagnosis of relapsed tumor (n=13). (C) Overall survival of the patients who received HDCT in pre-HDCT CR or PR status vs. SD or PD status from 1st HDCT (n=10).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908784&req=5

Figure 2: (A) Event free and overall survival of all patients at 3 year survival from diagnosis of relapsed tumor (n=15). (B) Event free and overall survival of the patients who received HDCT from when diagnosis of relapsed tumor (n=13). (C) Overall survival of the patients who received HDCT in pre-HDCT CR or PR status vs. SD or PD status from 1st HDCT (n=10).
Mentions: Three year OS and EFS rates of the total 15 patients from the time of relapse, were 33.3±12.2% and 26.7±11.4%, respectively (Fig. 2A). Of the 15 patients, 2 could not received HDCT(s) because 1 patient had rapidly progressive disease without preparing to do HDCT, and another patient died of sepsis during the period of SC. The 3-yr OS rate of the 13 patients who underwent HDCT(s) was 28.8±13.1% with a median follow-up of 21 months (range 9-44) after diagnosis of tumor relapse. Four patients are alive and event-free at 35, 38, 39 and 44 months since diagnosis of a relapsed tumor. Of 9 patients who had events, 8 experienced relapse or progression since HDCT1, and another had TRM at the time of HDCT1 and ASCT. Three-year EFS rates for these patients was 30.8±12.8% with a median follow-up of 16 months (range 7-44) after the diagnosis of relapsed tumor (Fig. 2B). There were no statistical differences in survival rates between the 2 groups of patients who received tandem (7 patients) or single (8 patients) transplantation (data not shown).

Bottom Line: The 3-yr overall survival probability and event-free survival rates +/-95% confidence intervals (CI) were 33.3+/-12.2% and 26.7% +/-11.4%, respectively.When analysis was confined to only patients who had a complete response (CR) or partial response (PR) prior to HDCT, the probability of 3-yr overall survival rates +/-95% CI was 40.0+/-15.5%.No patients with stable disease (SD) or progressive disease (PD) survived.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT
The efficacy and toxicity of high-dose chemotherapy and autologous stem cell transplantation (HDCT/ASCT) were investigated for improving the outcomes of patients with relapsed medulloblastoma. A total of 15 patients with relapsed medulloblastoma were enrolled in the KSPNO-S-053 study from May 2005 to May 2007. All patients received approximately 4 cycles of salvage chemotherapy after relapse. Thirteen underwent HDCT/ASCT; CTE and CM regimen were employed for the first HDCT (HDCT1) and second HDCT (HDCT2), respectively, and 7 underwent HDCT2. One transplant related mortality (TRM) due to veno-occlusive disease (VOD) occurred during HDCT1 but HDCT2 was tolerable with no further TRM. The 3-yr overall survival probability and event-free survival rates +/-95% confidence intervals (CI) were 33.3+/-12.2% and 26.7% +/-11.4%, respectively. When analysis was confined to only patients who had a complete response (CR) or partial response (PR) prior to HDCT, the probability of 3-yr overall survival rates +/-95% CI was 40.0+/-15.5%. No patients with stable disease (SD) or progressive disease (PD) survived. Survival rates from protocol KSPNO-S-053 are encouraging and show that tumor status prior to HDCT/ASCT is an important factor to consider for improving survival rates of patients with relapsed medulloblastoma.

Show MeSH
Related in: MedlinePlus