title: [High-dose therapy followed by auto HSCT in children--with advanced neuroblastoma in four transplant centres in Poland].
abstract: 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.
authors.affiliation: Klinika Hematologii i Onkologii Dzieciecej, ul. Chodzki 2, 20-093 Lublin, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Zaucha-Prazmo
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Drabko
authors.forename: Beata
authors.initials: B
authors.lastname: Wójcik
authors.forename: Marta
authors.initials: M
authors.lastname: Choma
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kałwak
authors.forename: Ewa
authors.initials: E
authors.lastname: Gorczyńska
authors.forename: Dominik
authors.initials: D
authors.lastname: Turkiewicz
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Słociak
authors.forename: Marek
authors.initials: M
authors.lastname: Ussowicz
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Dyla
authors.forename: Alicja
authors.initials: A
authors.lastname: Chybicka
authors.forename: Jolanta
authors.initials: J
authors.lastname: Goździk
authors.forename: Mariusz
authors.initials: M
authors.lastname: Ratajczak
authors.forename: Jan
authors.initials: J
authors.lastname: Styczyński
authors.forename: Robert
authors.initials: R
authors.lastname: Debski
authors.forename: Mariusz
authors.initials: M
authors.lastname: Wysocki
authors.forename: Jerzy
authors.initials: J
authors.lastname: Kowalczyk
mesh_terms: 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
chemical_list: D018906:Antineoplastic Agents, Alkylating