Autologous bone marrow transplantation in children with advanced neuroblastoma.
BACKGROUND
Encouraging results have been reported with high dose chemotherapy and total body radiation followed by bone marrow autotransplantation in children with advanced neuroblastoma; however, relapse remains a significant problem.


METHODS
The authors treated 22 children with advanced neuroblastoma with high dose chemotherapy, surgery, intraoperative radiation, and a bone marrow autotransplant (treated in vitro to remove tumor cells) followed by 13-cis-retinoic acid.


RESULTS
The 3-year relapse rate was 25% (95% confidence interval [CI], 6-44%). The 3-year disease free survival rate was 72% (95% CI, 52-92%). Toxicities included hemolytic uremic syndrome, herpes infection, and hepatic venoocclusive disease.


CONCLUSIONS
These data suggest that this treatment strategy offers an increased rate of 3-year disease free survival. The nonrandomized nature of this study and its use of multiple modalities precludes the analysis of the specific contribution of each treatment component and comparison with conventional therapy.
Department of Pediatrics, Nihon University, Tokyo, Japan.
H
H
Mugishima
M
M
Iwata
I
I
Okabe
E
E
Sanuki
N
N
Onuma
T
T
Fujimoto
M
M
Ohira
M
M
Kaneko
Y
Y
Tsuchida
M
M
Okuni
D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009447:Neuroblastoma / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome