Consolidation with a busulfan-containing regimen followed by stem cell transplantation in infants with poor prognosis stage 4 neuroblastoma.
Bone Marrow Transplant
; 25(9): 937-42, 2000 May.
Article
in En
| MEDLINE
| ID: mdl-10800060
ABSTRACT
Although infants with stage 4 neuroblastoma (NB) usually have a good prognosis, metastatic relapses after 1 year of age and amplification of the N-myc oncogene are established poor prognostic factors. In order to improve the survival of patients with such high-risk factors, we performed consolidation with a busulfan (600 mg/m2)-melphalan (140 mg/m2)-containing regimen followed by autologous stem cell transplantation (SCT). From 1986 to 1998, 12 patients were treated according to this strategy. Their median age at diagnosis was 9 months (1-11). Consolidation was performed after a metastatic relapse in five children, because of persistent bone metastases in one and as first-line consolidation in six patients whose tumor exhibited N-myc amplification. The 5-year EFS rate is 64. 5% (36-85%) with a median follow-up of 92 months (20-126). One toxicity-related death occurred in a very heavily pretreated patient. Hepatic veno-occlusive disease was the major side-effect that occurred in nine of 12 children. This busulfan-melphalan combination appears to dramatically improve the prognosis of these high-risk infants with metastatic NB. Given its high toxicity, indications for this consolidation must be restricted to high-risk infants and a lower dose of busulfan (480 mg/m2) is recommended in children weighing less than 10 kg. Bone Marrow Transplantation (2000) 25, 937-942.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain Neoplasms
/
Busulfan
/
Antineoplastic Combined Chemotherapy Protocols
/
Hematopoietic Stem Cell Transplantation
/
Immunosuppressive Agents
/
Neuroblastoma
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Infant
Language:
En
Journal:
Bone Marrow Transplant
Year:
2000
Document type:
Article