Hematopoietic Cell Transplantation for Pediatric Patients With Solid Tumors

Chen, Allen; Civin, Curt I.

doi:10.1002/9780470987070.ch99

Cited by 3 publications

(5 citation statements)

References 108 publications

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“…Multivariate analysis demonstrated that reduced risk of death was associated with receiving ASCT (relative risk, 0.26; 95% CI: 0.08-0.85). 25 Given the facts that (1) attempts to intensify conventional chemotherapy have not improved outcome, (2) in vitro data demonstrate sensitivity to melphalan and (3) alkylating agents have steep dose-response curves, there has been considerable interest in the use of ASCT as consolidation therapy for these high-risk patients. Kalambakas et al 26 recently published a comprehensive review of the literature which highlighted the conflicting findings regarding the usefulness of this approach.…”

Section: Discussionmentioning

confidence: 99%

“…Autologous stem cell transplantation (ASCT) has been employed as consolidation therapy for children with a variety of high-risk solid tumors. 1,2 The rationale for this approach is that many of these tumors are sensitive to chemotherapy and radiation, but because of steep doseresponse curves to both treatment modalities, relatively small dose reductions can result in sharp decreases in log tumor cell kill. 3 Phase I and II studies have demonstrated the activity of high-dose melphalan against tumors refractory to intensive conventional chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Autologous stem cell transplantation for high-risk Ewing's sarcoma and other pediatric solid tumors

Fraser

Weigel

Perentesis

et al. 2005

Bone Marrow Transplant

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The prognosis for many pediatric and young adult patients with solid tumors that have metastasized at the time of diagnosis or have relapsed after therapy remains very poor. The steep dose-response curve of many of these tumors to alkylating agents makes myeloablative chemotherapy followed by autologous stem cell transplantation (ASCT) an attractive potential therapy. The role of ASCT for these high-risk patients is yet to be conclusively determined. We have transplanted 36 patients on two consecutive protocols with a variety of histological diagnoses. Overall survival (OS) was 63% (95% CI: 47-79%) at 1 year and 33% (95% CI: 16-50%) at 3 years. Patients with a diagnosis of Ewing's sarcoma (ES) or desmoplastic small round cell tumor (DSRCT) had significantly better survival than those with other diagnoses with estimated 3-year OS of 54% (95% CI: 29-79%) for this group of patients (P = 0.03). There were two transplant-related deaths both attributable to hepatic veno-occlusive disease. Median follow-up among survivors is 3.5 years (range: 0.6-7.9 years). These data justify continued investigation of ASCT as a consolidation therapy in patients with metastatic or relapsed ES and DSRCT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Autologous stem cell transplantation for high-risk Ewing's sarcoma and other pediatric solid tumors

Fraser

Weigel

Perentesis

et al. 2005

Bone Marrow Transplant

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“…Several researchers have recently shown that tandem HDCT/autoSCT may also be a feasible method of improving the treatment outcome (2-5). This approach is based on the underlying hypothesis that additional dose escalation is likely to further enhance the survival of children with high-risk solid tumors.…”

Section: Introductionmentioning

confidence: 99%

“…The use of high-dose chemotherapy in conjunction with autologous stem cell transplantation (HDCT/autoSCT) has been demonstrated to increase the survival rate of children with high-risk solid tumors ( 1 ). Several researchers have recently shown that tandem HDCT/autoSCT may also be a feasible method of improving the treatment outcome ( 2 - 5 ). This approach is based on the underlying hypothesis that additional dose escalation is likely to further enhance the survival of children with high-risk solid tumors.…”

Section: Introductionmentioning

confidence: 99%

Iron Overload during Follow-up after Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Patients with High-Risk Neuroblastoma

et al. 2012

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Multiple RBC transfusions inevitably lead to a state of iron overload before and after high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT). Nonetheless, iron status during post-SCT follow-up remains unknown. Therefore, we investigated post-SCT ferritin levels, factors contributing to its sustained levels, and organ functions affected by iron overload in 49 children with high-risk neuroblastoma who underwent tandem HDCT/autoSCT. Although serum ferritin levels gradually decreased during post-SCT follow-up, 47.7% of the patients maintained ferritin levels above 1,000 ng/mL at 1 yr after the second HDCT/autoSCT. These patients had higher serum creatinine (0.62 vs 0.47 mg/mL, P = 0.007) than their counterparts (< 1,000 ng/mL). Post-SCT transfusion amount corresponded to increased ferritin levels at 1 yr after the second HDCT/autoSCT ( P < 0.001). A lower CD34 + cell count was associated with a greater need of RBC transfusion, which in turn led to a higher serum ferritin level at 1 yr after HDCT/autoSCT. The number of CD34 + cells transplanted was an independent factor for ferritin levels at 1 yr after the second HDCT/autoSCT ( P = 0.019). Consequently, CD34 + cells should be transplanted as many as possible to prevent the sustained iron overload after tandem HDCT/autoSCT and consequent adverse effects.

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“…Autologous stem cell transplantation (ASCT) has been employed as consolidation therapy for children with a variety of high-risk solid tumors. [8][9][10][11] The rationale for this approach is that many of these tumors are sensitive to chemotherapy and radiation, but because of steep dose-response curves to both treatment modalities, relatively small dose reductions can result in sharp decreases in log tumor cell kill. Phase I and II studies have demonstrated the activity of high-dose melphalan against tumors refractory to intensive conventional chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Myeloablative therapy against high risk Ewing's sarcoma: A single institution experience and literature review

López

Pérez

Márquez

et al. 2011

Reports of Practical Oncology & Radiotherapy

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Hematopoietic Cell Transplantation for Pediatric Patients With Solid Tumors

Cited by 3 publications

References 108 publications

Autologous stem cell transplantation for high-risk Ewing's sarcoma and other pediatric solid tumors

Autologous stem cell transplantation for high-risk Ewing's sarcoma and other pediatric solid tumors

Iron Overload during Follow-up after Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Patients with High-Risk Neuroblastoma

Myeloablative therapy against high risk Ewing's sarcoma: A single institution experience and literature review

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