title: High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma: long-term follow-up.
abstract: We previously reported a phase 2 trial of 69 patients with newly diagnosed anaplastic or aggressive oligodendroglioma who were treated with intensive procarbazine, CCNU (lomustine), and vincristine (PCV) followed by high-dose thiotepa with autologous stem cell rescue. This report summarizes the long-term follow-up of the cohort of 39 patients who received high-dose thiotepa with autologous stem cell support. Thirty-nine patients with a median age of 43 (range, 18-67) and a median KPS of 100 (range, 70-100) were treated. Surviving patients now have a median follow-up of 80.5 months (range, 44-142). The median progression-free survival is 78 months, and median overall survival has not been reached. Eighteen patients (46%) have relapsed. Neither histology nor prior low-grade oligodendroglioma correlated with risk of relapse. Persistent nonenhancing tumor at transplant was identified in our initial report as a significant risk factor for relapse; however, long-term follow-up has not confirmed this finding. Long-term neurotoxicity has developed only in those patients whose disease relapsed and required additional therapy; no patient in continuous remission has developed a delayed neurologic injury. This treatment strategy affords long-term disease control to a subset of patients with newly diagnosed anaplastic oligodendroglioma without evidence of delayed neurotoxicity or myelodysplasia.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. abreyl@mskcc.org
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Abrey
authors.forename: Barrett H
authors.initials: BH
authors.lastname: Childs
authors.forename: Nina
authors.initials: N
authors.lastname: Paleologos
authors.forename: Lynne
authors.initials: L
authors.lastname: Kaminer
authors.forename: Steven
authors.initials: S
authors.lastname: Rosenfeld
authors.forename: Donna
authors.initials: D
authors.lastname: Salzman
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Finlay
authors.forename: Sharon
authors.initials: S
authors.lastname: Gardner
authors.forename: Kendra
authors.initials: K
authors.lastname: Peterson
authors.forename: Wendy
authors.initials: W
authors.lastname: Hu
authors.forename: Lode
authors.initials: L
authors.lastname: Swinnen
authors.forename: Robert
authors.initials: R
authors.lastname: Bayer
authors.forename: Peter
authors.initials: P
authors.lastname: Forsyth
authors.forename: Douglas
authors.initials: D
authors.lastname: Stewart
authors.forename: Anne M
authors.initials: AM
authors.lastname: Smith
authors.forename: David R
authors.initials: DR
authors.lastname: Macdonald
authors.forename: Susan
authors.initials: S
authors.lastname: Weaver
authors.forename: David A
authors.initials: DA
authors.lastname: Ramsay
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Nimer
authors.forename: Lisa M
authors.initials: LM
authors.lastname: DeAngelis
authors.forename: J Gregory
authors.initials: JG
authors.lastname: Cairncross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001932:Brain Neoplasms / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008130:Lomustine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000401:mortality / Q000628:therapy*; D011344:Procarbazine / Q000008:administration & dosage; D016019:Survival Analysis; D013852:Thiotepa / Q000008:administration & dosage; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D013852:Thiotepa