[Megachemotherapy and autologous stem cell transplantation in children with Ewing sarcoma - Polish experience].
OBJECTIVE
To present results of megachemotherapy and autologus hematopoietic stem cell transplantation in children with Ewing sarcoma in 4 Polish pediatric transplantation centres.


METHODS
Between the years 1995-2007 autologous stem cell transplantation was performed in 54 patients (25 girls and 29 boys) with Ewing sarcoma. 26 patients were in complete remission before megachemotherapy, 23 were in partial remission, 3 patients had progression of the disease and the status of 2 patients was unknown. 41 children received busulfan 16 mg/kg and melphalan 140 mg/m(2), 8 children carboplatin 1500 mg/m(2), VP-16 40 mg/kg, melfalan 160 mg/m(2) and 5 children other megachemotherapy protocols.


RESULTS
Probability of survival of patients after transplantation, in complete remission is 0,79 with median 35 months of observation time. For patients after transplantation in partial remission probability of survival was 0,25 with median observation time of 14 months. Patients in progressive disease died 1,3 and 7 months after transplantation. 32 children are alive and 22 patients died, 21 of them due to disease progression.


CONCLUSIONS
1. Megachemotherapy and autologous hematopoietic stem cell transplantation is a safe therapy in patients with high risk Ewing sarcoma in complete remission. 2. Proportion of patients with sustained remission after transplantation in greater as compared to the published data related to high risk group without megachemotherapy. 3. According to our data megachemotherapy did not improve outcome in patients with partial remission of the disease.
Drabko
Katarzyna
K
Klinika Hematologii i Onkologii Dzieciecej, ul. Chodźki 2, 20-093 Lublin, Poland. k.drabko@am.lublin.pl
Zaucha-Prazmo
Agnieszka
A
Choma
Marta
M
Wójcik
Beata
B
Dyla
Agnieszka
A
Paździor
Dominika
D
Kałwak
Krzysztof
K
Chybicka
Alicja
A
Skoczeń
Szymon
S
Goździk
Jolanta
J
Styczyński
Jan
J
Wysocki
Mariusz
M
Kowalczyk
Jerzy
J
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D012074:Remission Induction; D012512:Sarcoma, Ewing / Q000401:mortality / Q000628:therapy*; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
D016190:Carboplatin; D002066:Busulfan; D008558:Melphalan