title: Hematologic recovery after tandem high-dose chemotherapy and autologous stem cell transplantation in children with high-risk solid tumors.
abstract: Although the number of studies using tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) for the treatment of high-risk pediatric solid tumors has been increasing, documentation of hematologic recovery after tandem HDCT/autoSCT is very limited. For this reason, we retrospectively analyzed the hematologic recovery of 236 children with high-risk solid tumors who underwent tandem HDCT/autoSCT. The median numbers of CD34(+) cells transplanted during the first and second HDCT/autoSCT were 4.3 × 10(6)/kg (range 0.6-220.2) and 4.1 × 10(6)/kg (range 0.9-157.6), respectively (P = 0.664). While there was no difference in neutrophil recovery between the first and second HDCT/autoSCT, platelet and RBC recoveries were significantly delayed in the second HDCT/autoSCT (P < 0.001 and P < 0.001, respectively). Delayed recovery in the second HDCT/autoSCT was more prominent when the number of transplanted CD34(+) cells was lower, especially if it was < 2 × 10(6)/kg. A lower CD34(+) cell count was also associated with increased RBC transfusion requirements and a higher serum ferritin level after tandem HDCT/autoSCT. More CD34(+) cells need to be transplanted during the second HDCT/autoSCT in order to achieve the same hematologic recovery as the first HDCT/autoSCT.
authors: Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Meong Hi
authors: MH
authors: Son
authors: Dong Hwan
authors: DH
authors: Kim
authors: Soo Hyun
authors: SH
authors: Lee
authors: Keon Hee
authors: KH
authors: Yoo
authors: Ki Woong
authors: KW
authors: Sung
authors: Hong Hoe
authors: HH
authors: Koo
authors: Ju Youn
authors: JY
authors: Kim
authors: Eun Joo
authors: EJ
authors: Cho
authors: Eun Suk
authors: ES
authors: Kang
authors: Dae Won
authors: DW
authors: Kim
mesh_terms: D000293:Adolescent; D018952:Antigens, CD34 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001772:Blood Cell Count; D001792:Blood Platelets / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004912:Erythrocytes / Q000166:cytology; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D009504:Neutrophils / Q000166:cytology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000166:cytology / Q000378:metabolism; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D005293:Ferritins
keywords: Autologous Stem Cell Transplantation; CD34 Cells; Hematologic Recovery; High-Dose Chemotherapy; Iron Overload
references: J Clin Oncol. 2006 Jun 20;24(18):2891-6
references: 16782928
references: Bone Marrow Transplant. 2007 Jul;40(1):37-45
references: 17468771
references: J Clin Oncol. 2000 Mar;18(6):1360-77
references: 10715309
references: Biol Blood Marrow Transplant. 2012 Oct;18(10):1564-72
references: 22683613
references: Eur J Haematol. 2007 Jan;78(1):21-8
references: 17042762
references: Blood Rev. 2009 Dec;23 Suppl 1:S15-9
references: 20116635
references: Lancet Oncol. 2006 Oct;7(10):813-20
references: 17012043
references: Pediatr Blood Cancer. 2007 Apr;48(4):408-15
references: 17066462
references: J Clin Oncol. 2009 Oct 1;27(28):4767-73
references: 19720922
references: Toxicology. 2002 Oct 30;180(1):23-32
references: 12324197
references: Vox Sang. 2009 Oct;97(3):185-97
references: 19663936
references: Blood. 2000 Jul 1;96(1):76-9
references: 10891433
references: N Engl J Med. 1999 Oct 14;341(16):1165-73
references: 10519894
references: J Clin Oncol. 2002 May 1;20(9):2284-92
references: 11980999
references: Leuk Lymphoma. 2001 Sep-Oct;42(5):863-70
references: 11697641
references: J Korean Med Sci. 2012 Apr;27(4):363-9
references: 22468098
references: Blood. 1996 Oct 15;88(8):3223-9
references: 8874224
references: Pediatr Blood Cancer. 2012 Mar;58(3):441-7
references: 21638755
references: Lancet Oncol. 2005 Sep;6(9):649-58
references: 16129365
references: Pediatr Blood Cancer. 2005 Apr;44(4):348-57
references: 15546135
references: Ann N Y Acad Sci. 2005;1054:40-7
references: 16339650