Successful treatment of metastatic retinoblastoma

Dunkel, Ira J.; Aledo, Alexander; Kernan, Nancy A.; Kushner, Brian H.; Bayer, Lisa A.; Gollamudi, Smitha; Finlay, Jonathan L.; Abramson, David H.

doi:10.1002/1097-0142(20001115)89:10<2117::aid-cncr12>3.0.co;2-9

Cited by 114 publications

(56 citation statements)

References 15 publications

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“…Although there have been several studies that employed HDCT/ASCR for the treatment of metastatic or relapsed retinoblastoma, [13][14][15][16] this is the first study of HDCT/ASCR in patients with newly diagnosed bilateral advanced retinoblastoma without extraocular metastasis. Vitreous seeds and subretinal fluid at diagnosis are known to be associated with a high chemoreduction failure rate.…”

Section: Discussionmentioning

confidence: 99%

Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma

et al. 2008

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma

et al. 2008

Bone Marrow Transplant

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“…Patients with metastatic disease outside the central nervous system (CNS) may be cured with high-dose chemotherapy and stem cell rescue [8,44]; however, these treatments usually are not available in LICs or most lower MICs. In cases with initial CNS involvement, subsequent relapse in the CNS often occurs after an initial response and ultimately causes death [42].…”

Section: Treating Patients With Overt Extraocular Diseasementioning

confidence: 99%

“…In developing countries, the diagnosis of retinoblastoma is frequently made at later stages of the disease when extraocular dissemination has already occurred; therefore, ocular and patient survival rates are lower in these countries than in developed countries [7]. When retinoblastoma extends outside the eye, it is difficult to cure, even with sophisticated and intense treatments [8]. Advanced extraocular retinoblastoma correlates with longer lag times from the onset of symptoms to the diagnosis [9,10].…”

Section: Introductionmentioning

confidence: 99%

Strategies to manage retinoblastoma in developing countries

Chantada

Qaddoumi

Canturk³

et al. 2010

Pediatric Blood & Cancer

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129

109

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Survival of retinoblastoma is >90% in developed countries but there are significant differences with developing countries in stage at presentation, available treatment options, family compliance, and survival. In low‐income countries (LICs), children present with advanced disease, and the reasons are socioeconomic and cultural. In middle‐income countries (MICs), survival rates are better (>70%), but there is a high prevalence of microscopically disseminated extraocular disease. Programs for eye preservation have been developed, but toxicity‐related mortality is higher. Although effective treatment of microscopically extraocular disease improved the outcome, worldwide survival will be increased only by earlier diagnosis and better treatment adherence. Pediatr Blood Cancer 2011;56:341–348. © 2010 Wiley‐Liss, Inc.

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“…All four were reported as having survived disease-free for 46-80 months from diagnosis of the metastatic disease. 29 Considering this experience and ours together, it can be cautiously concluded that HDC with carboplatin, etoposide and thiotepa produces long-term continuous remissions in patients with previous bone marrow and/or bone involvement by retinoblastoma and may even be able to control minimal residual disease in the CNS. The question of whether additional radiotherapy to the orbit or to sites High-dose chemotherapy with autologous stem cell B Kremens et al of parameningeal bone lesions is needed to prevent CNS relapse in patients with histologic involvement of the cut end of the optic nerve is still open.…”

Section: Discussionmentioning

confidence: 79%

High-dose chemotherapy with autologous stem cell rescue in children with retinoblastoma

Kremens

Wieland

Reinhard

et al. 2003

Bone Marrow Transplant

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Summary:Children with metastatic retinoblastoma are considered to have a poor prognosis after conventional chemotherapy. We used high-dose chemotherapy (HDC) with peripheral hematopoietic stem cell transplantation in such patients in an attempt to improve their survival. Four patients with bone marrow metastases and one child with extraorbital disease were treated with HDC after achieving complete remission by enucleation and conventional chemotherapy. The child with extraorbital tumor was the only one to receive local irradiation. The conditioning regimen included thiotepa (900 mg/m 2 ), etoposide (40 mg/kg) and carboplatin (1.5 g/m 2 ) in four patients, and BCNU (300 mg/m 2 ), cyclophosphamide (6.8 g/m 2 ) and etoposide (1.6 g/m 2 ) in one child. Hematologic recovery occurred without delay in all patients. The main toxicities were diarrhea, mucositis and infectious complications. No toxic deaths or any major late toxicities were observed. The child treated with the BCNU regimen developed a meningeal relapse 10 months after HDC, which was partially resected and treated with conventional chemotherapy, but not with radiotherapy. He is in complete remission (CR) 105 months off treatment. The other patients are in CCR for 107, 57, 9 and 8 months after HDC. HDC with thiotepa, etoposide and carboplatin may represent a curative option for children with extrabulbar or disseminated retinoblastoma responsive to chemotherapy. It may control occult CNS disease. The necessity to irradiate these children and the curative potential of this strategy for patients with bulky CNS disease remain to be determined.

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Successful treatment of metastatic retinoblastoma

Cited by 114 publications

References 15 publications

Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma

Tandem high-dose chemotherapy and autologous stem cell rescue in children with bilateral advanced retinoblastoma

Strategies to manage retinoblastoma in developing countries

High-dose chemotherapy with autologous stem cell rescue in children with retinoblastoma

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