Engraftment after myeloablative doses of131I-metaiodobenzylguanidine followed by autologous bone marrow transplantation for treatment of refractory neuroblastoma

Goldberg, Steven S.; DeSantes, Kenneth; Huberty, John P.; Price, David C.; Hasegawa, B.H.; Reynolds, C. Patrick; Seeger, Robert C.; Hattner, Robert S.; Matthay, Katherine K.

doi:10.1002/(sici)1096-911x(199806)30:6<339::aid-mpo7>3.0.co;2-f

Cited by 26 publications

(8 citation statements)

References 19 publications

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“…This is in contrast with data presented in other studies 13 which showed either slower or no recovery of platelets and red blood cells associated with particular risk factors. This difference could be connected to the patients' disease status and to previous treatments which seemed to be more favourable in our study group.…”

Section: Bone Marrow Transplantationmentioning

confidence: 99%

Megatherapy combining I131 metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma

Miano

Garaventa

Pizzitola

et al. 2001

Bone Marrow Transplant

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Summary:Despite the use of aggressive chemotherapy, stage 4 high risk neuroblastoma still has very poor prognosis which is estimated at 25%. Metabolic radiotherapy with I 131 MIBG appears a feasible option to enhance the effects of chemotherapy. Seventeen patients having MIBGpositive residual disease received 4.1-11.1 mCi/kg of I 131 MIBG 7-10 days before initiating the high-dose chemotherapy cycle consisting of busulphan 16 mg/kg and melphalan 140 mg/m 2 followed by PBSC infusion. We compared the toxicity in these patients to that seen in 15 control subjects with neuroblastoma who underwent a PBSC transplant without MIBG therapy. We observed greater toxic involvement of the gastrointestinal system in children treated with I strategy includes inductive chemotherapy, mainly based on ozaphorines and platine derivatives followed by surgery and a consolidation phase including megatherapy with stem cell rescue. Conditioning regimens combining high-dose chemotherapy with total body irradiation have been abandoned due to unsatisfactory results and severe late effects. In a Children's Cancer Group (CCG) study, the event-free survival (EFS) of children receiving high-dose (HD) chemotherapy with peripheral blood stem cell transplantation (PBSC) rescue was 34% reaching 46% when followed by further therapy with 13 cis-retinoic acid treatment. 1 Targeted radiotherapy with I 131 metaiodobenzylguanidine (MIBG) has proven to be active in advanced neuroblastoma (NB) and insertion in the megatherapy regimen is promising. In fact, I 131 MIBG, that concentrates in the neuroblastoma cells, is potentially capable of selectively delivering a substantial radiation dose to neoplastic cells while sparing normal tissues. We report on the feasibility of this approach in 17 patients with advanced NB. Fifteen children with NB receiving a similar myeloablative conditioning regimen without I 131 MIBG are evaluated and reported as controls. Our experience suggests that including I 131 MIBG in the conditioning regimen followed by PBSC rescue in children taking up MIBG is a feasible therapeutic strategy, although attention should be paid to avoiding lung complications. Patients and methods Patients' characteristics and first line therapyFrom October 1994 to February 2000 17 patients suffering from either stage 3 (one patient) or 4 (16 patients) neuroblastoma and having positive MIBG residual disease were treated with MIBG megatherapy followed by high-dose chemotherapy with PBSC rescue. Ten were females and seven were males. Median age at diagnosis was 3 years (range 1-9). Median time between diagnosis and megatherapy was 7 months (range 4-46). NB origin was adrenal in seven cases, retroperitoneal gangliar in seven cases, abdominal in two, and unknown in one.

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Section: Bone Marrow Transplantationmentioning

confidence: 99%

Megatherapy combining I131 metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma

Miano

Garaventa

Pizzitola

et al. 2001

Bone Marrow Transplant

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“…Since 131 I-MIBG concentrates in neuroblastoma tumors, it is potentially capable of selectively delivering a substantial radiation dose to the neuroblastoma cells in both primary tumors and metastases [4]. 131 I-MIBG therapy has been used in children with neuroblastoma who were resistant to conventional therapy and, more recently, as front line therapy with promising results [4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Biodistribution of post‐therapeutic versus diagnostic ¹³¹I‐MIBG scans in children with neuroblastoma

Hickeson

Charron

Maris

et al. 2003

Pediatric Blood & Cancer

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“…MIBG labeled with 131 I demonstrated activity for targeted therapy of neuroblastoma, both in relapsed and newly diagnosed patients (61)(62)(63). As a single agent in a phase 1 dose-escalation study in children with relapsed neuroblastoma, 131 I-MIBG showed a 37% response rate (64), and dose-limiting hematologic toxicity was circumvented with autologous peripheral blood stem cell rescue (65,66). Another study showed a 36% response rate, and an additional 34% of patients demonstrated stable disease after 131 I-MIBG therapy (67).…”

Section: Rationalementioning

confidence: 99%

MIBG in Neuroblastoma Diagnostic Imaging and Therapy

Sharp¹,

Trout²,

Weiss³

et al. 2016

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Neuroblastoma is a common malignancy observed in infants and young children. It has a varied prognosis, ranging from spontaneous regression to aggressive metastatic tumors with fatal outcomes despite multimodality therapy. Patients are divided into risk groups on the basis of age, stage, and biologic tumor factors. Multiple clinical and imaging tests are needed for accurate patient assessment. Iodine 123 ((123)I) metaiodobenzylguanidine (MIBG) is the first-line functional imaging agent used in neuroblastoma imaging. MIBG uptake is seen in 90% of neuroblastomas, identifying both the primary tumor and sites of metastatic disease. The addition of single photon emission computed tomography (SPECT) and SPECT/computed tomography to (123)I-MIBG planar images can improve identification and characterization of sites of uptake. During scan interpretation, use of MIBG semiquantitative scoring systems improves description of disease extent and distribution and may be helpful in defining prognosis. Therapeutic use of MIBG labeled with iodine 131 ((131)I) is being investigated as part of research trials, both as a single agent and in conjunction with other therapies. (131)I-MIBG therapy has been studied in patients with newly diagnosed neuroblastoma and those with relapsed disease. Development and implementation of an institutional (131)I-MIBG therapy research program requires extensive preparation with a focus on radiation protection.

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Engraftment after myeloablative doses of131I-metaiodobenzylguanidine followed by autologous bone marrow transplantation for treatment of refractory neuroblastoma

Cited by 26 publications

References 19 publications

Megatherapy combining I131 metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma

Megatherapy combining I131 metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma

Biodistribution of post‐therapeutic versus diagnostic ¹³¹I‐MIBG scans in children with neuroblastoma

MIBG in Neuroblastoma Diagnostic Imaging and Therapy

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Engraftment after myeloablative doses of131I-metaiodobenzylguanidine followed by autologous bone marrow transplantation for treatment of refractory neuroblastoma

Cited by 26 publications

References 19 publications

Megatherapy combining I131 metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma

Megatherapy combining I131 metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma

Biodistribution of post‐therapeutic versus diagnostic 131I‐MIBG scans in children with neuroblastoma

MIBG in Neuroblastoma Diagnostic Imaging and Therapy

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Biodistribution of post‐therapeutic versus diagnostic ¹³¹I‐MIBG scans in children with neuroblastoma