title: High-dose busulphan/melphalan with autologous stem cell rescue in Ewing's sarcoma.
abstract: Eighteen patients with poor risk Ewing's sarcoma (including 11 patients with metastatic disease at presentation) received consolidation therapy of busulphan and melphalan with autologous stem cell rescue. There were nine females. The median age at diagnosis was 14.2 years (range 2.75-30 years). There was one early death due to cytomegalovirus pneumonitis. One patient developed a single generalised convulsion during busulphan therapy. Severe renal toxicity was not encountered. One patient developed veno-occlusive disease of the liver (VOD) which eventually resolved. With a median follow up of 2 years, 13 patients survive including six with initial metastatic disease. We conclude that high-dose busulphan/melphalan is well-tolerated and should be evaluated for efficacy in a larger series of patients with high risk Ewing's sarcoma.
authors.affiliation: Department of Paediatric Oncology, The Royal Marsden NHS Trust, Sutton, Surrey, UK.
authors.forename: A
authors.initials: A
authors.lastname: Atra
authors.forename: J S
authors.initials: JS
authors.lastname: Whelan
authors.forename: V
authors.initials: V
authors.lastname: Calvagna
authors.forename: A G
authors.initials: AG
authors.lastname: Shankar
authors.forename: S
authors.initials: S
authors.lastname: Ashley
authors.forename: V
authors.initials: V
authors.lastname: Shepherd
authors.forename: R L
authors.initials: RL
authors.lastname: Souhami
authors.forename: C R
authors.initials: CR
authors.lastname: Pinkerton
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002998:Clonazepam / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000075202:Contraindications; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D009362:Neoplasm Metastasis; D010672:Phenytoin; D012074:Remission Induction; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D012640:Seizures / Q000139:chemically induced / Q000517:prevention & control; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D002998:Clonazepam; D010672:Phenytoin; D002066:Busulfan; D008558:Melphalan