title: Treatment of high-risk neuroblastoma with triple-tandem high-dose therapy and stem-cell rescue: results of the Chicago Pilot II Study.
abstract: OBJECTIVE
  To investigate whether intensive induction therapy followed by triple-tandem cycles of high-dose therapy with peripheral-blood stem-cell rescue and local irradiation will improve event-free survival for patients with high-risk neuroblastoma.
  
  
  METHODS
  From August 1995 to January 2000, 25 consecutive newly diagnosed high-risk neuroblastoma patients and one child with recurrent MYCN-amplified disease were enrolled onto the Chicago Pilot II Protocol. After induction therapy and surgery, peripheral-blood stem cells were mobilized with three cycles of high-dose cyclophosphamide and granulocyte colony-stimulating factor. Patients then underwent triple-tandem cycles of high-dose therapy with peripheral-blood stem-cell rescue followed by radiation to the primary site.
  
  
  RESULTS
  Twenty-two of the 26 patients successfully completed induction therapy and were eligible for the triple-tandem consolidation high-dose therapy. Sufficient numbers of peripheral-blood stem cells were collected in all but one patient. Seventeen patients were able to complete all three cycles of high-dose therapy and peripheral-blood stem-cell rescue, two patients completed two cycles, and three patients completed one cycle. There was one toxic death, and one patient died from complications of treatment for graft failure. With a median follow-up of 38 months, the 3-year event-free survival and survival rates are 57% +/- 11% and 79% +/- 10%, respectively.
  
  
  CONCLUSIONS
  The results of this pilot study demonstrate that it is feasible to intensify consolidation with triple-tandem high-dose chemotherapy and peripheral-blood stem-cell rescue and local irradiation, and suggest that this treatment strategy may lead to improved survival for patients with high-risk neuroblastoma.
authors: Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. mkletzel@northwestern.edu
authors: Morris
authors: M
authors: Kletzel
authors: Howard M
authors: HM
authors: Katzenstein
authors: Paul R
authors: PR
authors: Haut
authors: Alice L
authors: AL
authors: Yu
authors: Elaine
authors: E
authors: Morgan
authors: Marleta
authors: M
authors: Reynolds
authors: Grant
authors: G
authors: Geissler
authors: Maryanne H
authors: MH
authors: Marymount
authors: Dachao
authors: D
authors: Liu
authors: John A
authors: JA
authors: Kalapurakal
authors: Richard M
authors: RM
authors: Shore
authors: Diana M E
authors: DM
authors: Bardo
authors: Jennifer
authors: J
authors: Schmoldt
authors: Alfred W
authors: AW
authors: Rademaker
authors: Susan L
authors: SL
authors: Cohn
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009447:Neuroblastoma / Q000628:therapy*; D010865:Pilot Projects; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome