title: High-dose chemotherapy and autologous stem cell rescue in patients with high-risk stage 3 neuroblastoma: 10-year experience at a single center.
abstract: High-dose chemotherapy and autologous stem cell rescue (HDCT/ASCR) was applied to improve the prognosis of patients with high-risk stage 3 neuroblastoma. From January 1997 to December 2006, 28 patients were newly diagnosed as stage 3 neuroblastoma. Nine of 11 patients with N-myc amplification and 5 of 17 patients without N-myc amplification (poor response in 2 patients, persistent residual tumor in 2 and relapse in 1) underwent single or tandem HDCT/ASCR. Patients without high-risk features received conventional treatment modalities only. While 8 of 9 patients underwent single HDCT/ASCR and the remaining one patient underwent tandem HDCT/ASCR during the early study period, all 5 patients underwent tandem HDCT/ASCR during the late period. Toxicities associated with HDCT/ASCR were tolerable and there was no treatment-related mortality. While the tumor relapsed in two of eight patients in single HDCT/ASCR group, all six patients in tandem HDCT/ASCR group remained relapse free. The 5-yr event-free survival (EFS) from diagnosis, in patients with N-myc amplification, was 71.6+/-14.0%. In addition, 12 of 14 patients who underwent HDCT/ASCR remained event free resulting in an 85.1+/-9.7% 5-yr EFS after the first HDCT/ASCR. The present study demonstrates that HDCT/ASCR may improve the survival of patients with high-risk stage 3 neuroblastoma.
authors: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jung Min
authors: JM
authors: Suh
authors: Keon Hee
authors: KH
authors: Yoo
authors: Ki Woong
authors: KW
authors: Sung
authors: Ju Youn
authors: JY
authors: Kim
authors: Eun Joo
authors: EJ
authors: Cho
authors: Hong Hoe
authors: HH
authors: Koo
authors: Suk Koo
authors: SK
authors: Lee
authors: Jhingook
authors: J
authors: Kim
authors: Do Hoon
authors: DH
authors: Lim
authors: Yeon Lim
authors: YL
authors: Suh
authors: Dae Won
authors: DW
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D016271:Proto-Oncogene Proteins c-myc / Q000032:analysis / Q000235:genetics; D011994:Recombinant Proteins; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous
chemical_list: D016271:Proto-Oncogene Proteins c-myc; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor