title: Graft versus tumor effect in the brain of a child with recurrent metastatic medulloblastoma.
abstract: Marrow ablative chemotherapy (MAC) with autologous hematopoietic stem cell transplantation (HSCT) is limited by poor bone marrow reserve after chemotherapy and/or radiotherapy, and the extent of bone/bone marrow disease. We report a child with recurrent metastatic medulloblastoma who received an allogeneic HSCT while in relapse and subsequently achieved radiological resolution of disease and favorable marrow minimal residual disease (MRD) response. Disease recurred intra-cranially at 304 days post-HSCT. Tumor biopsy 488 days post-HSCT showed infiltration with donor lymphocytes demonstrating graft-versus-tumor (GVT) effect. The patient remained alive >2 years post-HSCT. Allogeneic HSCT may be a consideration for high-risk recurrent medulloblastoma.
authors.affiliation: Division of Hematology, Oncology, Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California.
authors.forename: Hisham
authors.initials: H
authors.lastname: Abdel-Azim
authors.affiliation: Division of Hematology, Oncology, Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California.
authors.forename: Neena
authors.initials: N
authors.lastname: Kapoor
authors.affiliation: Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Kris M
authors.initials: KM
authors.lastname: Mahadeo
authors.affiliation: Division of Hematology, Oncology and BMT, Nationwide Children's Hospital, Ohio State University, Columbus, Ohio.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Finlay
mesh_terms: D064591:Allografts; D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy; D002528:Cerebellar Neoplasms / Q000628:therapy*; D059248:Chemoradiotherapy; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D017809:Fatal Outcome; D020350:Graft vs Tumor Effect; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology; D008297:Male; D008527:Medulloblastoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D008577:Meningeal Neoplasms / Q000556:secondary* / Q000628:therapy; D009364:Neoplasm Recurrence, Local; D016879:Salvage Therapy; D019172:Transplantation Conditioning
keywords: allogeneic stem cell transplantation; graft versus tumor effect in brain; medulloblastoma