title: Myeloablative therapy with autologous stem cell rescue for patients with Ewing sarcoma.
abstract: The aim of this study was to identify risk factors associated with PFS in patients with Ewing sarcoma undergoing ASCT; 116 patients underwent ASCT in 1989-2000 and reported to the Center for International Blood and Marrow Transplant Research. Eighty patients (69%) received ASCT as first-line therapy and 36 (31%), for recurrent disease. Risk factors affecting ASCT were analyzed with use of the Cox regression method. Metastatic disease at diagnosis, recurrence prior to ASCT and performance score <90 were associated with higher rates of disease recurrence/progression. Five-year probabilities of PFS in patients with localized and metastatic disease at diagnosis who received ASCT as first-line therapy were 49% (95% CI 30-69) and 34% (95% CI 22-47) respectively. The 5-year probability of PFS in patients with localized disease at diagnosis, and received ASCT after recurrence was 14% (95% CI 3-30). PFS rates after ASCT are comparable to published rates in patients with similar disease characteristics treated with conventional chemotherapy, surgery and irradiation suggesting a limited role for ASCT in these patients. Therefore, ASCT if considered should be for high-risk patients in the setting of carefully controlled clinical trials.
authors.affiliation: Department of Pediatric Oncology, New York University, New York, NY, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Gardner
authors.forename: J
authors.initials: J
authors.lastname: Carreras
authors.forename: C
authors.initials: C
authors.lastname: Boudreau
authors.forename: B M
authors.initials: BM
authors.lastname: Camitta
authors.forename: R H
authors.initials: RH
authors.lastname: Adams
authors.forename: A R
authors.initials: AR
authors.lastname: Chen
authors.forename: S M
authors.initials: SM
authors.lastname: Davies
authors.forename: J R
authors.initials: JR
authors.lastname: Edwards
authors.forename: A C
authors.initials: AC
authors.lastname: Grovas
authors.forename: G A
authors.initials: GA
authors.lastname: Hale
authors.forename: H M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: M
authors.initials: M
authors.lastname: Arora
authors.forename: P J
authors.initials: PJ
authors.lastname: Stiff
authors.forename: M
authors.initials: M
authors.lastname: Eapen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D012307:Risk Factors; D012512:Sarcoma, Ewing / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D016019:Survival Analysis; D014182:Transplantation, Autologous
chemical_list: D019653:Myeloablative Agonists