Repeated high-dose chemotherapy followed by purged autologous bone marrow transplantation as consolidation therapy in metastatic neuroblastoma.
Among 62 children over 1 year of age at diagnosis, who were treated for stage IV neuroblastoma, 33 entered complete remission (CR) or good partial remission (GPR) after conventional therapy and received high-dose chemotherapy (HDC) with in vitro purged autologous bone marrow transplantation (ABMT) as consolidation therapy. The HDC was a combination of carmustine (BCNU), teniposide (VM-26), and melphalan. Thirty-three patients received one course of this regimen, and 18 received two courses. At present, 16 of the 33 grafted patients are alive in continuous CR, with a median follow-up of 28 months. Toxicity of this regimen was tolerable, principally marked by bone marrow depression and gastrointestinal (GI) tract complications. Four complication-related deaths were observed. Relapse post-ABMT occurred most often in the bone marrow. Under this treatment, actuarial disease-free survival is improved compared with that observed under conventional therapy.
Hartmann
O
O
Benhamou
E
E
Beaujean
F
F
Kalifa
C
C
Lejars
O
O
Patte
C
C
Behard
C
C
Flamant
F
F
Thyss
A
A
Deville
A
A
D000008:Abdominal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000139:chemically induced; D016026:Bone Marrow Transplantation; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007223:Infant; D007239:Infections / Q000139:chemically induced; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D009447:Neuroblastoma / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D013713:Teniposide / Q000008:administration & dosage / Q000009:adverse effects; D013899:Thoracic Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D013713:Teniposide; D002945:Cisplatin; D008558:Melphalan; D002330:Carmustine