Treatment of metastatic retinoblastoma.
OBJECTIVE
The risk for death in patients with retinoblastoma is increased in those who present with metastatic disease, and the role of intensive chemotherapy and autologous hematopoietic stem cell rescue in these patients remains unclear.


METHODS
Nonrandomized interventional case series.


METHODS
Four consecutive patients with metastatic retinoblastoma.


METHODS
We treated four patients with retinoblastoma metastatic to the bone and bone marrow with intensive chemotherapy, consolidation with megatherapy, and autologous hematopoietic stem cell rescue. Chemotherapy included courses of carboplatin and etoposide alternating with cyclophosphamide, etoposide, and either carboplatin or cisplatin. Radiation therapy was delivered to areas of bone metastases.


METHODS
Patient survival.


RESULTS
All patients completed and responded to the scheduled therapy; complete response of the bone marrow disease was documented after two courses of chemotherapy in all cases. Two patients are long-term survivors.


CONCLUSIONS
The treatment described has been successful in obtaining disease-free survival in patients with metastatic retinoblastoma.
Rodriguez-Galindo
Carlos
C
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. carlos.rodriguez-galindo@stjude.org
Wilson
Matthew W
MW
Haik
Barrett G
BG
Lipson
Mindy J
MJ
Cain
Alvida
A
Merchant
Thomas E
TE
Kaste
Sue
S
Pratt
Charles B
CB
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019046:Bone Marrow Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D002675:Child, Preschool; D018572:Disease-Free Survival; D015353:Eye Enucleation; D005134:Eye Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D018714:Radiotherapy, Adjuvant; D012175:Retinoblastoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy*