[Myeloablative chemo- and radiotherapy with autologous and allogenic bone marrow reconstitution in children with metastatic neuroblastoma].
22 children with metastatic neuroblastoma received myeloablative chemoradiotherapy followed by bone marrow transplantation (BMT). The duration of preceding chemotherapy was 4-30 months and included treatment of recurrences in 10 children. At BMT 12 patients were in CR, 9 in PR and one had tumor progression. 10/15 of autologous bone marrows were purged using immunomagnetic bead method of Kemshead and 2/15 using 4 hydroperoxycyclophosphamide. Myeloablative therapy consisted of melphalan and total body irradiation (TBI) in 13 patients (three each supplemented by vincristine or adriamycin/etoposide), in one child of melphalan and mIBG and in 3 children of melphalan alone. 3 children received double autograft and 2 cyclophosphamide (and TBI). 10 patients survived 0-32 months from BMT and 5-48 months from diagnosis, respectively. 12 patients died including 7/12 of tumor progression and 5/12 of toxicity (venoocclusive disease, gut toxicity, septicemia, pneumonia). We conclude that at this point BMT after conventional high dose chemotherapy may provide the only real chance of survival for a significant number of children with metastatic neuroblastoma.
Berthold
F
F
Universitäts-kinderkliniken Köln.
Bender-Götze
C
C
Dopfer
R
R
Erttmann
R
R
Haas
R J
RJ
Henze
G
G
Körbling
M
M
Riehm
H
H
Rister
M
M
Stollmann
B
B
D000008:Abdominal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D000310:Adrenal Gland Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects / Q000528:radiation effects; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009362:Neoplasm Metastasis; D009447:Neuroblastoma / Q000188:drug therapy* / Q000532:radiotherapy; D013899:Thoracic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy
Myeloablative Chemo- und Radiotherapie mit autologer und allogener Knochenmarksrekonstitution bei Kindern mit metastasiertem Neuroblastom.