High-dose chemotherapy and autologous peripheral blood stem cell transplantation in adult patients with high-risk or advanced Ewing and soft tissue sarcoma.
OBJECTIVE
Despite the availability of combined-modality treatment for Ewing sarcoma (ES) and soft tissue sarcomas (STS), results from independent groups still indicate a poor prognosis for high-risk and metastasized patients. The benefit of high-dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (ASCT) as compared to standard treatment is not defined.


METHODS
Here, we report of HDCT in 35 consecutive adult patients with poor-risk ES or rhabdomyosarcoma (n = 11) and STS (n = 24) undergoing ASCT between July 1992 and March 2003. At a median follow-up of 100.6 months after ASCT, 11 patients are alive, with nine in sustained complete remission (CR) and each one in partial remission (PR) and stable disease. Median overall survival (OS) from ASCT was 17.1 months. Response to pretreatment, Karnofsky index > 80%, R (0) resection and first-line ASCT were associated with long-term OS (p < 0.05).


CONCLUSIONS
These data indicate that (1) patients achieving a CR or PR following induction, with preserved performance status and R (0) resection may benefit from ASCT and (2) that this can be an useful therapeutic modality in a subset of patients, in some achieving remarkable responses.
Engelhardt
M
M
Department of Hematology and Oncology, Freiburg University Medical Center, Hugstetterstrasse 55, 79106 Freiburg, Germany. monika.engelhardt@uniklinik-freiburg.de
Zeiser
R
R
Ihorst
G
G
Finke
J
J
Müller
C I
CI
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D036102:Peripheral Blood Stem Cell Transplantation / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012208:Rhabdomyosarcoma / Q000628:therapy; D012307:Risk Factors; D012509:Sarcoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome