TY - JOUR
T1 - Tandem high-dose therapy in rapid sequence for children with high-risk neuroblastoma
AU - Grupp, Stephan A.
AU - Stern, Julie W.
AU - Bunin, Nancy
AU - Nancarrow, Cheryl
AU - Ross, Amy A.
AU - Mogul, Mark
AU - Adams, Roberta
AU - Grier, Holcombe E.
AU - Gorlin, Jed B.
AU - Shamberger, Robert
AU - Marcus, Karen
AU - Neuberg, Donna
AU - Weinstein, Howard J.
AU - Diller, Lisa
PY - 2000/7
Y1 - 2000/7
N2 - Purpose: Advances in chemotherapy and supportive care have slowly improved survival rates for patients with high-risk neuroblastoma. The focus of many of these chemotherapeutic advances has been dose intensification. In this phase II trial involving children with advanced neuroblastoma, we used a program of induction chemotherapy followed by tandem high-dose, myeloablative treatments (high-dose therapy) with stem-cell rescue (HDT/SCR) in rapid sequence. Patients and Methods: Patients underwent induction chemotherapy during which peripheral-blood stem and progenitor cells were collected and local control measures undertaken. Patients then received tandem courses of HDT/SCR, 4 to 6 weeks apart. Thirty-nine patients (age 1 to 12 years) were assessable, and 70 cycles of HDT/SCR were completed. Results: Pheresis was possible in the case of all patients, despite their young ages, with an average of 7.2 x 106 CD34+ cells/kg available to support each cycle. Engraftment was rapid; median time to neutrophil engraftment was 11 days. Four patients who completed the first HDT course did not complete the second, and there were three deaths due to toxicity. With a median follow-up of 22 months (from diagnosis), 26 of 39 patients remained event-free. The 3-year event-free survival rate for these patients was 58%. Conclusion: A tandem HDT/SCR regimen for high-risk neuroblastoma is a feasible treatment strategy for children and may improve disease-free survival. (C) 2000 by American Society of Clinical Oncology.
AB - Purpose: Advances in chemotherapy and supportive care have slowly improved survival rates for patients with high-risk neuroblastoma. The focus of many of these chemotherapeutic advances has been dose intensification. In this phase II trial involving children with advanced neuroblastoma, we used a program of induction chemotherapy followed by tandem high-dose, myeloablative treatments (high-dose therapy) with stem-cell rescue (HDT/SCR) in rapid sequence. Patients and Methods: Patients underwent induction chemotherapy during which peripheral-blood stem and progenitor cells were collected and local control measures undertaken. Patients then received tandem courses of HDT/SCR, 4 to 6 weeks apart. Thirty-nine patients (age 1 to 12 years) were assessable, and 70 cycles of HDT/SCR were completed. Results: Pheresis was possible in the case of all patients, despite their young ages, with an average of 7.2 x 106 CD34+ cells/kg available to support each cycle. Engraftment was rapid; median time to neutrophil engraftment was 11 days. Four patients who completed the first HDT course did not complete the second, and there were three deaths due to toxicity. With a median follow-up of 22 months (from diagnosis), 26 of 39 patients remained event-free. The 3-year event-free survival rate for these patients was 58%. Conclusion: A tandem HDT/SCR regimen for high-risk neuroblastoma is a feasible treatment strategy for children and may improve disease-free survival. (C) 2000 by American Society of Clinical Oncology.
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U2 - 10.1200/JCO.2000.18.13.2567
DO - 10.1200/JCO.2000.18.13.2567
M3 - Article
C2 - 10893288
AN - SCOPUS:0033917099
SN - 0732-183X
VL - 18
SP - 2567
EP - 2575
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 13
ER -