High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma: long-term follow-up.
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.
Abrey
Lauren E
LE
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. abreyl@mskcc.org
Childs
Barrett H
BH
Paleologos
Nina
N
Kaminer
Lynne
L
Rosenfeld
Steven
S
Salzman
Donna
D
Finlay
Jonathan L
JL
Gardner
Sharon
S
Peterson
Kendra
K
Hu
Wendy
W
Swinnen
Lode
L
Bayer
Robert
R
Forsyth
Peter
P
Stewart
Douglas
D
Smith
Anne M
AM
Macdonald
David R
DR
Weaver
Susan
S
Ramsay
David A
DA
Nimer
Stephen D
SD
DeAngelis
Lisa M
LM
Cairncross
J Gregory
JG
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
D000970:Antineoplastic Agents; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D013852:Thiotepa