High-dose chemotherapy with autologous stem cell transplantation in adults with recurrent embryonal tumors of the central nervous system

Paula Gill, Mark R Litzow, Jan Craig Buckner, Carola A.S. Arndt, Timothy Moynihan, Teresa Christianson, Stephen Maxted Ansell, Evanthia Galanis

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18 Citations (Scopus)

Abstract

BACKGROUND. Embryonal central nervous system (CNS) tumors (medulloblastoma, cerebral neuroblastoma, pineoblastoma, and primitive neuroectodermal tumors) are rare in adults. Recurrent disease has an extremely poor outcome. The use of high-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) has demonstrated promising results in children with recurrent disease, but there are only limited data regarding its role in adults. The purpose of the current study was to evaluate adult patients with embryonal CNS tumors who were treated with HDC with ASCT and compare their outcomes with those of patients who received conventional-dose chemotherapy. METHODS. The authors reviewed the medical records of 23 adult patients (age ≥18 years) who were treated at the Mayo Clinic for recurrent embryonal CNS tumors between 1976 and 2004. The authors compared treatment with HDC with ASCT (10 patients) with an historic control of patients treated with conventional-dose chemotherapy (nitrosourea based, cisplatin based, or both) (13 patients). RESULTS. HDC with ASCT was associated with increased survival (P = .044) and a longer time to disease progression (TTP) (P = .028). The conventional-dose chemotherapy group had a median TTP of 0.58 years and a median survival of 2.00 years. The HDC with ASCT group had a median TTP of 1.25 years and a median survival of 3.47 years. When restricted to patients receiving ASCT after first disease recurrence, the median TTP was 2.5 years and the median survival was 4.16 years. Toxicities were similar in both groups. CONCLUSIONS. Improvements in the median TTP and survival noted with the administration of HDC with ASCT, as well as the acceptable toxicity of this regimen, supports consideration of its use in adults with recurrent embryonal CNS tumors.

Original languageEnglish (US)
Pages (from-to)1805-1811
Number of pages7
JournalCancer
Volume112
Issue number8
DOIs
StatePublished - Apr 15 2008

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Central Nervous System Neoplasms
Stem Cell Transplantation
Drug Therapy
Disease Progression
Survival
Pinealoma
Primitive Neuroectodermal Tumors
Medulloblastoma
Neuroblastoma
Cisplatin
Medical Records
Recurrence

Keywords

  • Autologous stem cell transplantation
  • Embryonal central nervous system tumors
  • High-dose chemotherapy
  • Medulloblastoma
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{546da756fbaf4b56b1d6c09aad8651d0,
title = "High-dose chemotherapy with autologous stem cell transplantation in adults with recurrent embryonal tumors of the central nervous system",
abstract = "BACKGROUND. Embryonal central nervous system (CNS) tumors (medulloblastoma, cerebral neuroblastoma, pineoblastoma, and primitive neuroectodermal tumors) are rare in adults. Recurrent disease has an extremely poor outcome. The use of high-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) has demonstrated promising results in children with recurrent disease, but there are only limited data regarding its role in adults. The purpose of the current study was to evaluate adult patients with embryonal CNS tumors who were treated with HDC with ASCT and compare their outcomes with those of patients who received conventional-dose chemotherapy. METHODS. The authors reviewed the medical records of 23 adult patients (age ≥18 years) who were treated at the Mayo Clinic for recurrent embryonal CNS tumors between 1976 and 2004. The authors compared treatment with HDC with ASCT (10 patients) with an historic control of patients treated with conventional-dose chemotherapy (nitrosourea based, cisplatin based, or both) (13 patients). RESULTS. HDC with ASCT was associated with increased survival (P = .044) and a longer time to disease progression (TTP) (P = .028). The conventional-dose chemotherapy group had a median TTP of 0.58 years and a median survival of 2.00 years. The HDC with ASCT group had a median TTP of 1.25 years and a median survival of 3.47 years. When restricted to patients receiving ASCT after first disease recurrence, the median TTP was 2.5 years and the median survival was 4.16 years. Toxicities were similar in both groups. CONCLUSIONS. Improvements in the median TTP and survival noted with the administration of HDC with ASCT, as well as the acceptable toxicity of this regimen, supports consideration of its use in adults with recurrent embryonal CNS tumors.",
keywords = "Autologous stem cell transplantation, Embryonal central nervous system tumors, High-dose chemotherapy, Medulloblastoma, Survival",
author = "Paula Gill and Litzow, {Mark R} and Buckner, {Jan Craig} and Arndt, {Carola A.S.} and Timothy Moynihan and Teresa Christianson and Ansell, {Stephen Maxted} and Evanthia Galanis",
year = "2008",
month = "4",
day = "15",
doi = "10.1002/cncr.23362",
language = "English (US)",
volume = "112",
pages = "1805--1811",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
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TY - JOUR

T1 - High-dose chemotherapy with autologous stem cell transplantation in adults with recurrent embryonal tumors of the central nervous system

AU - Gill, Paula

AU - Litzow, Mark R

AU - Buckner, Jan Craig

AU - Arndt, Carola A.S.

AU - Moynihan, Timothy

AU - Christianson, Teresa

AU - Ansell, Stephen Maxted

AU - Galanis, Evanthia

PY - 2008/4/15

Y1 - 2008/4/15

N2 - BACKGROUND. Embryonal central nervous system (CNS) tumors (medulloblastoma, cerebral neuroblastoma, pineoblastoma, and primitive neuroectodermal tumors) are rare in adults. Recurrent disease has an extremely poor outcome. The use of high-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) has demonstrated promising results in children with recurrent disease, but there are only limited data regarding its role in adults. The purpose of the current study was to evaluate adult patients with embryonal CNS tumors who were treated with HDC with ASCT and compare their outcomes with those of patients who received conventional-dose chemotherapy. METHODS. The authors reviewed the medical records of 23 adult patients (age ≥18 years) who were treated at the Mayo Clinic for recurrent embryonal CNS tumors between 1976 and 2004. The authors compared treatment with HDC with ASCT (10 patients) with an historic control of patients treated with conventional-dose chemotherapy (nitrosourea based, cisplatin based, or both) (13 patients). RESULTS. HDC with ASCT was associated with increased survival (P = .044) and a longer time to disease progression (TTP) (P = .028). The conventional-dose chemotherapy group had a median TTP of 0.58 years and a median survival of 2.00 years. The HDC with ASCT group had a median TTP of 1.25 years and a median survival of 3.47 years. When restricted to patients receiving ASCT after first disease recurrence, the median TTP was 2.5 years and the median survival was 4.16 years. Toxicities were similar in both groups. CONCLUSIONS. Improvements in the median TTP and survival noted with the administration of HDC with ASCT, as well as the acceptable toxicity of this regimen, supports consideration of its use in adults with recurrent embryonal CNS tumors.

AB - BACKGROUND. Embryonal central nervous system (CNS) tumors (medulloblastoma, cerebral neuroblastoma, pineoblastoma, and primitive neuroectodermal tumors) are rare in adults. Recurrent disease has an extremely poor outcome. The use of high-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) has demonstrated promising results in children with recurrent disease, but there are only limited data regarding its role in adults. The purpose of the current study was to evaluate adult patients with embryonal CNS tumors who were treated with HDC with ASCT and compare their outcomes with those of patients who received conventional-dose chemotherapy. METHODS. The authors reviewed the medical records of 23 adult patients (age ≥18 years) who were treated at the Mayo Clinic for recurrent embryonal CNS tumors between 1976 and 2004. The authors compared treatment with HDC with ASCT (10 patients) with an historic control of patients treated with conventional-dose chemotherapy (nitrosourea based, cisplatin based, or both) (13 patients). RESULTS. HDC with ASCT was associated with increased survival (P = .044) and a longer time to disease progression (TTP) (P = .028). The conventional-dose chemotherapy group had a median TTP of 0.58 years and a median survival of 2.00 years. The HDC with ASCT group had a median TTP of 1.25 years and a median survival of 3.47 years. When restricted to patients receiving ASCT after first disease recurrence, the median TTP was 2.5 years and the median survival was 4.16 years. Toxicities were similar in both groups. CONCLUSIONS. Improvements in the median TTP and survival noted with the administration of HDC with ASCT, as well as the acceptable toxicity of this regimen, supports consideration of its use in adults with recurrent embryonal CNS tumors.

KW - Autologous stem cell transplantation

KW - Embryonal central nervous system tumors

KW - High-dose chemotherapy

KW - Medulloblastoma

KW - Survival

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DO - 10.1002/cncr.23362

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SN - 0008-543X

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