1070 myeloablative megatherapy procedures followed by stem cell rescue for neuroblastoma: 17 years of European experience and conclusions

Philip, Thierry; Ladenstein, Ruth; Lasset, Christine; Hartmann, Olivier; Zucker, J M; Pinkerton, Ross; Pearson, Andrew; Klingebiel, Thomas; Garaventa, Alberto; Kremens, B; Bernard, Jean‐Louis; Rosti, Giovanni; Chauvin, Franck

doi:10.1016/s0959-8049(97)00324-9

Cited by 95 publications

(57 citation statements)

References 10 publications

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“…18,20 Kushner and co-workers documented moderate-to-severe high-frequency hearing loss (Brock grade 2-4) in 84% of high-risk NB patients following induction therapy and ASCT. 20 Although the post-transplant relapse rate is reduced in patients with responsive disease compared to historical series, [1][2][3]5 the overall burden of therapy is high and the range of toxicities in long-term survivors excessive. We believe that TBI is a major contributor to their genesis.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11] Features associated with an improved prognosis include younger age 5,7 and absence of bone marrow involvement at diagnosis, 12 early disease response 13 and a complete or near complete response following induction therapy. 6,7,10,14 A poorer prognosis has been associated with an elevated serum ferritin (4143 ng/ ml), 6 bone and BM metastasis, 6 detectable circulating NB cells at diagnosis, 15,16 persisting skeletal and BM disease at the end of induction therapy, 1,2 circulating NB cells in patients otherwise apparently disease-free 16 and high-level of NB contamination at marrow harvest.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

Trahair

Vowels

Johnston

et al. 2007

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

Trahair

Vowels

Johnston

et al. 2007

Bone Marrow Transplant

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“…Long-term survival of children with inoperable or disseminated neuroblastoma diagnosed after the age of 1 year remains largely unsatisfactory mainly because current treatment commonly fails to eradicate the disease (Garaventa et al, 1993;Haase et al, 1995;Philip et al, 1997). Thus, until innovative and more effective therapies are developed the paediatric oncologist dealing with refractory or partially responsive neuroblastoma must struggle to optimize the therapeutic tools at his disposal (Castleberry et al, 1991;Gaze et al, 1995;Leavey et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

131I-metaiodobenzylguanidine (131I-MIBG) therapy for residual neuroblastoma: a mono-institutional experience with 43 patients

et al. 1999

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Incomplete response to therapy may compromise the outcome of children with advanced neuroblastoma. In an attempt to improve tumour response we incorporated 131 I-metaiodobenzylguanidine ( 131 I-MIBG) in the treatment regimens of selected stage 3 and stage 4 patients. Between 1986 and 1997, 43 neuroblastoma patients older than 1 year at diagnosis, 13 with stage 3 (group A) and 30 with stage 4 disease (group B) who had completed the first-line protocol without achieving complete response entered in this study. 131 I-MIBG dose/course ranged from 2.5 to 5.5 Gbq (median, 3.7). The number of courses ranged from 1 to 5 (median 3) depending on the tumour response and toxicity. The most common acute side-effect was thrombocytopenia. Later side-effects included severe interstitial pneumonia in one patient, acute myeloid leukaemia in two, reduced thyroid reserve in 21. Complete response was documented in one stage 4 patient, partial response in 12 (two stage 3, 10 stage 4), mixed or no response in 25 (ten stage 3, 15 stage 4) and disease progression in five (one stage 3, four stage 4) Twenty-four patients (12/13 stage 3, 12/30 stage 4) are alive at 22–153 months (median, 59) from diagnosis. 131 I-MIBG therapy may increase the cure rate of stage 3 and improve the response of stage 4 neuroblastoma patients with residual disease after first-line therapy. A larger number of patients should be treated to confirm these results but logistic problems hamper prospective and coordinated studies. Long-term toxicity can be severe. © 1999 Cancer Research Campaign

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“…[1][2][3][4] The main cause of failure after HDCT/auto-SCT is relapse or tumor progression rather than treatment-related mortality (TRM). In this context, some investigators have explored the efficacy of double or triple tandem HDCT/auto-SCT to further improve the outcome of high-risk neuroblastoma patients.…”

Section: Introductionmentioning

confidence: 99%

Tandem high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk neuroblastoma: Results of SMC NB-2004 study

Sung

Son

Lee

et al. 2012

Bone Marrow Transplant

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, 50 consecutive patients with high-risk neuroblastoma were assigned to receive tandem HDCT (high-dose chemotherapy)/auto-SCT after nine cycles of induction chemotherapy. CEC (carboplatin þ etoposide þ cyclophosphamide) regimen and TM (thiotepa þ melphalan)-TBI regimen (or TM regimen for stage 3 patients) were the first and second HDCT regimens. Local radiotherapy, differentiation therapy with 13-cis-retinoid acid and immunotherapy with interleukin-2 were given after tandem HDCT/auto-SCT. Of the 50 patients, 49 underwent a first HDCT/auto-SCT and 47 underwent a second HDCT/auto-SCT. The tumor relapsed or progressed in 14 patients, secondary malignancy developed in one patient and one patient died from chronic lung disease. Therefore, 34 patients remained event free with a median follow-up of 54.5 months (range, 14-94 months) from diagnosis. The probabilities of 5-year OS and EFS for all 50 patients were 77.0% (95% confidence interval (CI), 63.7-90.3) and 71.4% (95% CI, 58.7-84.1), respectively. However, all patients who remained event free for 43 years after tandem HDCT/auto-SCT experienced late adverse effects. Chemotherapeutic dose-escalation strategy using tandem HDCT/auto-SCT was very encouraging for survival. However, further studies incorporating newer treatment modalities are needed to reduce late adverse effects without jeopardizing the survival rate.

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1070 myeloablative megatherapy procedures followed by stem cell rescue for neuroblastoma: 17 years of European experience and conclusions

Cited by 95 publications

References 10 publications

Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

131I-metaiodobenzylguanidine (131I-MIBG) therapy for residual neuroblastoma: a mono-institutional experience with 43 patients

Tandem high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk neuroblastoma: Results of SMC NB-2004 study

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