title: High-dose Chemotherapy With Autologous Stem Cell Rescue in Saudi Children Less Than 3 Years of Age With Embryonal Brain Tumors.
abstract: High-dose chemotherapy with autologous stem cell rescue (HDC/ASCR) has been used in children under the age of 3 years with embryonal brain tumors to avoid or delay the use of radiation. We reviewed the medical records of 10 Saudi children less than 3 years of age with embryonal brain tumors who underwent HDC/ASCR. All 10 patients underwent surgical resection followed by 3 to 5 cycles of induction chemotherapy and 1 to 3 cycles of HDC/ASCR using carboplatin and thiotepa. Isotretinoin was used as a maintenance therapy in 4 patients. Five patients had medulloblastoma, 3 had atypical teratoid/rhabdoid tumors, 1 had an embryonal tumor with abundant neuropil and true rosettes, and 1 had pineoblastoma. The median age of the patients was 1.9 years. A total of 19 HDC/ASCR procedures were performed. Radiotherapy (RT) was administered to 5 patients after HDC/ASCR and as a salvage therapy in 1 patient. The progression-free survival rate was 50% at 1 year and at 2 years, with a median follow-up of 24 months. All 5 patients with medulloblastoma are still alive without evidence of disease, but the other patients died secondary to tumor progression. This experience suggests that strategies combining myeloablative chemotherapy and autologous stem cell rescue appear to be feasible for children with embryonal brain tumors in the Middle East.
authors.affiliation: *Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs †Department of Pediatrics, College of Medicine, King Saud University ‡Department of Pediatric Hematology Oncology, Comprehensive Cancer Centre §Department of Pathology ∥Department of Radiation Oncology, King Fahad Medical City, Riyadh ¶Department of Pediatric Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Alsultan
authors.forename: Musa
authors.initials: M
authors.lastname: Alharbi
authors.forename: Sadeq
authors.initials: S
authors.lastname: Al-Dandan
authors.forename: Yasser
authors.initials: Y
authors.lastname: Bayoumi
authors.forename: Talal
authors.initials: T
authors.lastname: Alharbi
authors.forename: Reem
authors.initials: R
authors.lastname: Alsudairy
authors.forename: Ali
authors.initials: A
authors.lastname: Alomari
authors.forename: Khalid
authors.initials: K
authors.lastname: Aljamaan
authors.forename: Othman
authors.initials: O
authors.lastname: Musleh
authors.forename: Qasim
authors.initials: Q
authors.lastname: Alharbi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Jarrar
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012529:Saudi Arabia; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D008727:Methotrexate