title: [Long-term effect of high dose chemotherapy combined with stem cell transplantation on stage IV neuroblastoma in children].
abstract: OBJECTIVE
  Neuroblastoma is a highly malignant tumor. Stage IV neuroblastoma has a very poor long-term outcome by conventional chemotherapy and surgery and better therapies are essential. This study aimed to explore the long-term effect of high dose induction chemotherapy combined with autologous peripheral blood stem cell transplantation and 13-cis retinoid acid treatment on stage IV neuroblastoma in children.
  
  
  METHODS
  Twenty-eight children with stage IV neuroblastoma, aged 2.1-11.5 years (mean 3.3 +/- 1.9 years), were employed for the study. Primary sites of the tumors included adrenal (n=23), chest (n=3), chest-abdomen (n=1) and sacrum (n=1). Before autologous peripheral blood stem cell transplantation the patients received 6 courses of intensive induction chemotherapy. During chemotherapy the autologous peripheral blood stem cells were harvested and the tumor excision was done. After transplantation the local radiation and 13-cis retinoid acid therapy were administered.
  
  
  RESULTS
  After 6 courses of induction chemotherapy 13 patients got complete remission (CR), 11 got partial remission (PR), and 4 had no response. The 24 patients who received CR or PR completed the full therapy. A 3.5 +/- 0.7 years follow-up showed that the 4-year event-free survival of the CR and PR patients was 29.2%. The median no-relapse survival time in CR patients was 4.1 +/- 0.7 years but 2.8 +/- 0.5 years in PR patients (t= 3.9, P < 0.01).
  
  
  CONCLUSIONS
  High dose chemotherapy combined with autologous peripheral stem cell transplantation and 13 cis-retinoid acid treatment can improve the long-term outcome of patients with stage IV neuroblastoma. The patients in CR before transplantation had better outcomes than those in PR.
authors.affiliation: Department of Pediatrics, General Hospital of People's Liberation Army, Beijing 100853, China. suoqin@yahoo.com
authors.forename: Suo-Qin
authors.initials: SQ
authors.lastname: Tang
authors.forename: Dong-Sheng
authors.initials: DS
authors.lastname: Huang
authors.forename: Jian-Wen
authors.initials: JW
authors.lastname: Wang
authors.forename: Cheng
authors.initials: C
authors.lastname: Feng
authors.forename: Guang
authors.initials: G
authors.lastname: Yang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000473:pathology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D014182:Transplantation, Autologous