title: High dose therapy for recurrent Wilms' tumor.
abstract: The prognosis for most patients with newly diagnosed Wilms' tumor (WT) is excellent, but those who have recurrent or refractory disease have a significantly worse prognosis. High dose chemotherapy (HDT) requiring autologous stem-cell rescue has been tried for recurrent WT with variable results, but no randomized clinical trial has ever been performed. A recent review by T.C. Ha and colleagues of the published cases to date suggests HDT may be beneficial to the very high risk subset of patients with recurrent WT, but this conclusion is fraught with the caveats of any retrospective review. A prospective clinical trial would be challenging to complete but with careful planning and international collaboration it could be accomplished. Such a trial is likely the only way to know with certainty the safety and efficacy of HDT for recurrent WT.
authors.affiliation: Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: McLean
keywords: Wilms’ tumor (WT); autologous stem-cell rescue; high dose chemotherapy (HDT); recurrent; relapse
references.citation: Pediatr Blood Cancer. 2010 Oct;55(4):763-5
references.pmid: 20589657
references.citation: Mol Cancer Ther. 2013 Dec;12(12):2619-27
references.pmid: 24258344
references.citation: Pediatr Blood Cancer. 2013 Jun;60(6):994-1000
references.pmid: 23255438
references.citation: Pediatr Nephrol. 2013 Jan;28(1):13-23
references.pmid: 22461142
references.citation: Expert Rev Anticancer Ther. 2005 Oct;5(5):835-46
references.pmid: 16221053
references.citation: Expert Rev Anticancer Ther. 2009 Dec;9(12):1807-15
references.pmid: 19954292
references.citation: J Korean Med Sci. 2006 Jun;21(3):436-40
references.pmid: 16778385
references.citation: Pediatr Nephrol. 2014 May;29(5):815-23; quiz 821
references.pmid: 23760992
references.citation: Oncologist. 2012;17(2):250-9
references.pmid: 22291091
references.citation: J Pediatr Hematol Oncol. 2010 Aug;32(6):454-61
references.pmid: 20505538
references.citation: Pediatr Transplant. 2011 Dec;15(8):855-60
references.pmid: 22060039
references.citation: Klin Padiatr. 2011 May;223(3):113-9
references.pmid: 21509706
references.citation: Pediatr Blood Cancer. 2008 Feb;50(2):236-41
references.pmid: 17539021
references.citation: Eur J Cancer. 2013 Jan;49(1):194-210
references.pmid: 22959164
references.citation: Ther Apher Dial. 2011 Dec;15(6):579-86
references.pmid: 22107695