[High-dose therapy followed by auto HSCT in children--with advanced neuroblastoma in four transplant centres in Poland].
OBJECTIVE
Posttransplant morbidity and clinical outcome in children with advanced neuroblastoma (NBL) who underwent megachemotherapy followed by HSCT were investigated.


METHODS
In the study 73 children with advanced NBL treated in four Departments of Paediatric Haematology and Oncology in Lublin, Kraków, Wrocław and Bydgoszcz from 1995 to 2004 were analysed. Median age of children was 4.9 years (range 1.8 to 15). Reinfusion of CD34 cells followed myeloablative chemotherapy with Busulfan / Melfalan in 58 patients; Treosulfan / Melfalan in 2 patients; Melfalan / VP16/ Carbo in 9 patient, Melfalan alone in 3 patients and Thiotepa /CTX/ Carbo in 1 patient. Stem cells from peripheral blood were used in 57 cases, bone marrow in 10 patients, bone marrow and peripheral blood in 6 patients.


RESULTS
41/73 (56%) children are alive with median follow up 12 months (range 3 to 68 months), 29 children are in complete remission (CR), 12 patients are in partial remission (PR). 32/73 (44%) children died, 26 of them due to progressive disease; six children died due to posttransplantation complications. Overall survival (OS) at median observation time 12 months is 0.65; disease free survival (DFS) is 0.58. Probability of 5-year OS and DFS in the group of children transplanted in first partial/complete remission are 0.42 and 0.4 respectively.


CONCLUSIONS
Treatment with megachemotherapy followed by autoHSCT in patients with advanced neuroblastoma has not many adverse effects. Probabilities of 5-year OS and DFS are higher in the group of transplanted children in 1 partial/complete remission than in children transplanted after relapse.
Zaucha-Prazmo
Agnieszka
A
Klinika Hematologii i Onkologii Dzieciecej, ul. Chodzki 2, 20-093 Lublin, Poland.
Drabko
Katarzyna
K
Wójcik
Beata
B
Choma
Marta
M
Kałwak
Krzysztof
K
Gorczyńska
Ewa
E
Turkiewicz
Dominik
D
Słociak
Małgorzata
M
Ussowicz
Marek
M
Dyla
Agnieszka
A
Chybicka
Alicja
A
Goździk
Jolanta
J
Ratajczak
Mariusz
M
Styczyński
Jan
J
Debski
Robert
R
Wysocki
Mariusz
M
Kowalczyk
Jerzy
J
D000046:Academic Medical Centers; D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000188:drug therapy / Q000628:therapy*; D016522:Oncology Service, Hospital; D011044:Poland; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018906:Antineoplastic Agents, Alkylating