title: High-dose chemotherapy followed by autologous and allogeneic peripheral blood stem cell transplantation for recurrent disseminated trilateral retinoblastoma.
abstract: BACKGROUND
  Trilateral retinoblastoma (TRb) is an intracranial neurogenic tumor associated with unilateral or bilateral retinoblastoma and has very poor prognosis. Patients typically die from leptomeningeal tumor dissemination.
  
  
  METHODS
  A 3-year-old girl who had been diagnosed with TRb had a disseminated relapse after a tumorectomy, cerebrospinal irradiation, and conventional chemotherapy. The disseminated tumor disappeared after the first autologous peripheral blood stem cell transplantation (PBSCT) with high-dose melphalan and thiotepa. During the second complete remission, a second autologous PBSCT with high-dose busulfan and melphalan was performed. Seven months after the first PBSCT, the second relapse occurred, and we subsequently performed an allogeneic PBSCT with myeloablative chemotherapy consisting of melphalan, thiotepa, and cyclophosphamide. The patient showed clinical improvement after the allogeneic PBSCT.
  
  
  CONCLUSIONS
  Although high-dose chemotherapies have a curative effect for some patients with TRb, the prognoses of disseminated tumors are still poor. Further examination of the high-dose chemotherapy is necessary for the time, the conditioning drugs, and the hematopoietic stem cell sources.
authors.affiliation: Department of Clinical Examination, National Hospital Organization Kumamoto Medical Center, 1-5, Ninomaru, Kumamoto-shi, Kumamoto, 860-0008, Japan. ttsuruta@kumamoto2.hosp.go.jp
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Tsuruta
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Aihara
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kanno
authors.forename: Chikako
authors.initials: C
authors.lastname: Kiyotani
authors.forename: Katsuya
authors.initials: K
authors.lastname: Maebayashi
authors.forename: Masako
authors.initials: M
authors.lastname: Sakauchi
authors.forename: Makiko
authors.initials: M
authors.lastname: Osawa
authors.forename: Hisaichi
authors.initials: H
authors.lastname: Fujii
authors.forename: Osami
authors.initials: O
authors.lastname: Kubo
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D019572:Retinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D012175:Retinoblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous