High-dose chemotherapy and autologous haematopoietic stem cell rescue for children with high-risk neuroblastoma

Abstract

Based on the currently available evidence, myeloablative therapy seems to be a good treatment option for children with high-risk neuroblastoma. It results in higher survival rates than conventional therapy, although possible higher levels of adverse effects should be kept in mind. A definitive conclusion regarding the effect of myeloablative therapy in different subgroups is not possible. This systematic review only allows a conclusion on the concept of myeloablative therapy; no conclusions can be made regarding the best treatment strategy. Future trials on the use of myeloablative therapy for high-risk neuroblastoma should focus on identifying the most optimal induction and/or myeloablative regimen. The best study design to answer these questions is a RCT. These RCTs should be performed in homogeneous study populations (for example, regarding stage of disease and patient age) and have a long-term follow up. Different risk groups should be taken into account.

Inflammatory myofibroblastic tumor of the liver after adrenal neuroblastoma surgery: a case report

“…Irradiation and drug therapy used as adjuvant modalities during the preoperative and postoperative period may have contributed to the development of the new tumor [ 18 ]. In addition, a patient’s genetic susceptibility to cancer, other environmental factors, or unknown causes may also lead to the development of a second tumor [ 19 , 20 ]. Low-dose irradiation is known to induce a second tumor [ 21 ].…”

Inflammatory myofibroblastic tumor of the liver after adrenal neuroblastoma surgery: a case report

“…Irradiation and drug therapy used as adjuvant modalities during the preoperative and postoperative period may have contributed to the development of the new tumor [ 18 ]. In addition, a patient’s genetic susceptibility to cancer, other environmental factors, or unknown causes may also lead to the development of a second tumor [ 19 , 20 ]. Low-dose irradiation is known to induce a second tumor [ 21 ].…”

Role of the extent of prophylactic regional lymph node radiotherapy on survival in high‐risk neuroblastoma: A report from the COG A3973 study

“…Notably, radiotherapy is implicated in numerous late toxicities of multimodal neuroblastoma treatment including impairment in musculoskeletal growth, fertility, and cardiopulmonary function, as well as endocrinopathies, bladder dysfunction, poor psychosocial health, and secondary malignancies . Radiation fields covering prophylactic nodal stations are by definition larger than fields encompassing gross disease alone and, therefore, confirming the lack of benefit for such extended fields will likely limit future radiation‐associated toxicities.…”

Terapia wysokodawkowa z przeszczepieniem autologicznych komórek krwiotwórczych u dzieci z nerwiakiem zarodkowym i mięsakiem Ewinga

“…Based on the currently available evidence, myeloablative therapy seems to work in terms of disease-free survival in NBL [3]. For patients with high-risk NBL treated with chemoradiotherapy, surgery, and auto-HSCT, the addition of anti-disialoganglioside (GD2) immunotherapy plus cytokines is expected to improve survival.…”

Inflammatory myofibroblastic tumor of the liver after adrenal neuroblastoma surgery: a case report

“…Irradiation and drug therapy used as adjuvant modalities during the preoperative and postoperative period may have contributed to the development of the new tumor [ 18 ]. In addition, a patient’s genetic susceptibility to cancer, other environmental factors, or unknown causes may also lead to the development of a second tumor [ 19 , 20 ]. Low-dose irradiation is known to induce a second tumor [ 21 ].…”

Role of the extent of prophylactic regional lymph node radiotherapy on survival in high‐risk neuroblastoma: A report from the COG A3973 study

“…Notably, radiotherapy is implicated in numerous late toxicities of multimodal neuroblastoma treatment including impairment in musculoskeletal growth, fertility, and cardiopulmonary function, as well as endocrinopathies, bladder dysfunction, poor psychosocial health, and secondary malignancies . Radiation fields covering prophylactic nodal stations are by definition larger than fields encompassing gross disease alone and, therefore, confirming the lack of benefit for such extended fields will likely limit future radiation‐associated toxicities.…”

Terapia wysokodawkowa z przeszczepieniem autologicznych komórek krwiotwórczych u dzieci z nerwiakiem zarodkowym i mięsakiem Ewinga

“…Based on the currently available evidence, myeloablative therapy seems to work in terms of disease-free survival in NBL [3]. For patients with high-risk NBL treated with chemoradiotherapy, surgery, and auto-HSCT, the addition of anti-disialoganglioside (GD2) immunotherapy plus cytokines is expected to improve survival.…”

Inflammatory myofibroblastic tumor of the liver after adrenal neuroblastoma surgery: a case report

“…Irradiation and drug therapy used as adjuvant modalities during the preoperative and postoperative period may have contributed to the development of the new tumor [ 18 ]. In addition, a patient’s genetic susceptibility to cancer, other environmental factors, or unknown causes may also lead to the development of a second tumor [ 19 , 20 ]. Low-dose irradiation is known to induce a second tumor [ 21 ].…”

Role of the extent of prophylactic regional lymph node radiotherapy on survival in high‐risk neuroblastoma: A report from the COG A3973 study

“…Notably, radiotherapy is implicated in numerous late toxicities of multimodal neuroblastoma treatment including impairment in musculoskeletal growth, fertility, and cardiopulmonary function, as well as endocrinopathies, bladder dysfunction, poor psychosocial health, and secondary malignancies . Radiation fields covering prophylactic nodal stations are by definition larger than fields encompassing gross disease alone and, therefore, confirming the lack of benefit for such extended fields will likely limit future radiation‐associated toxicities.…”

Terapia wysokodawkowa z przeszczepieniem autologicznych komórek krwiotwórczych u dzieci z nerwiakiem zarodkowym i mięsakiem Ewinga

“…Based on the currently available evidence, myeloablative therapy seems to work in terms of disease-free survival in NBL [3]. For patients with high-risk NBL treated with chemoradiotherapy, surgery, and auto-HSCT, the addition of anti-disialoganglioside (GD2) immunotherapy plus cytokines is expected to improve survival.…”