title: [Effectiveness of high-dose polychemotherapy with autologous hemopoietic stem cell transplantation in the treatment for malignant tumors of the central nervous system in children and young adults].
abstract: A total of 40 patients (median age 6 years, range 1-28 years) with high-risk malignant brain tumors received a single (n = 35) or tandem (n = 5) high-dose chemotherapy (HDCT) with autologous hemopoietic stem cell transplantation (auto-HSCT). The 2-year OS and DFS are 52% and 47%, accordingly, with median follow-up of 24 (range 2-96) months. The patients without complete response at the time of auto-HSCT had worst prognosis with 53% DFS in patients with partial remission and 25% in patients with disease stabilization (p = 0.001). Patients with relapsed tumor had worse prognosis, than high-risk patients in the first remission with DFS 26% and 62%, accordingly (p=0.02). The relapse rate also correlated with patient's age (38% DFS in patients younger, than 4 years and 60% in older patients, p = 0.005) and tumor morphology (63% DFS in patients with medulloblastoma, 60% in patients with germ-cell tumors, 45% in other embryonal CNS tumors, p = 0.05). The 4th-grade transplant-related toxicity and mortality rates were observed in 13% and 18% of patients, accordingly. Therefore, HDCT with auto-HSCT in young patients with high-risk CNS tumors is characterized by acceptable toxicity and allows improving overall therapy results.
authors.forename: A G
authors.initials: AG
authors.lastname: Gevorgyan
authors.forename: E V
authors.initials: EV
authors.lastname: Morozova
authors.forename: I V
authors.initials: IV
authors.lastname: Kazantsev
authors.forename: Yu A
authors.initials: YA
authors.lastname: Punanov
authors.forename: S A
authors.initials: SA
authors.lastname: Safonova
authors.forename: T V
authors.initials: TV
authors.lastname: Yukhta
authors.forename: T V
authors.initials: TV
authors.lastname: Andreeva
authors.forename: L S
authors.initials: LS
authors.lastname: Zubarovskaya
authors.forename: O G
authors.initials: OG
authors.lastname: Zheludkova
authors.forename: B V A
authors.initials: BV
authors.lastname: Fanasiev
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011379:Prognosis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult