Successful treatment of metastatic rhabdomyosarcoma with radiochemotherapy and allogeneic hematopoietic stem cell transplantation.
We report a case of a 21-year-old man with alveolar rhabdomyosarcoma primarily in the right hand with lymph node, lung, bone and bone marrow metastases. Complete remission was achieved after intensive chemotherapy and radiotherapy of the primary and metastatic sites, followed by allogeneic peripheral blood stem cell transplantation with reduced-intensity conditioning from a single HLA-DR locus-mismatched mother. The patient remained relapse-free for 41 months after the diagnosis. Considering that the conventional treatment for rhabdomyosarcoma with multiple risk factors (old age, bone or bone marrow involvement, unfavorable primary sites and ≥ 3 metastases) is associated with a poor prognosis (5% probability of a 3-year event-free survival), the graft-versus-tumor effect may have contributed to his sustained relapse-free survival. Allogeneic hematopoietic stem cell transplantation for rhabdomyosarcoma should be done by experienced clinical oncologists on properly designed controlled trials.
Department of Pediatrics, Keio University School of Medicine, Tokyo.
Fumito
F
Yamazaki
Department of Pediatrics, Keio University School of Medicine, Tokyo.
Tomoo
T
Osumi
Department of Radiology, Keio University School of Medicine, Tokyo.
Naoyuki
N
Shigematsu
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Hideo
H
Morioka
Department of Pediatrics, Keio University School of Medicine, Tokyo hshimada@a5.keio.jp.
Hiroyuki
H
Shimada
D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D012074:Remission Induction; D012208:Rhabdomyosarcoma / Q000473:pathology* / Q000628:therapy*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemotherapy; rhabdomyosarcoma; stem cell transplantation