Tandem high-dose chemotherapy and auto-SCT for malignant brain tumors in children under 3 years of age

Abstract

In an effort to improve survival and reduce late adverse effects of radiation therapy (RT), 25 children o3 years of age with malignant brain tumors received tandem high-dose chemotherapy (HDCT) and auto-SCT following six cycles of induction chemotherapy. RT was either not given or deferred until 3 years of age if the patient was in CR after tandem HDCT/auto-SCT. Tumors relapsed or progressed in nine patients (five during induction treatment), and two of these patients survived after receiving salvage treatment, including RT. Two patients died due to toxicities during tandem HDCT/auto-SCT. A total of 16 patients survived to a median follow-up period of 52 months (range 18-96) from the time of diagnosis. Four of these patients did not receive RT, two received local RT (L-RT), three received craniospinal RT (CSRT), and seven received both L-RT and CSRT. The 5-year OS and EFS rates were 67.8 ± 9.4% and 55.5 ± 10.0%, respectively. Neuroendocrine and neurocognitive functions evaluated 3 years after tandem HDCT/auto-SCT were acceptable. Our results indicate that tandem HDCT/auto-SCT may improve survival in young children with malignant brain tumors with an acceptable level of risk of long-term toxicity.

High-dose chemotherapy (HDCT) with auto-SCT in children with atypical teratoid/rhabdoid tumors (AT/RT): a report from the European Rhabdoid Registry (EU-RHAB)

“…5,8,[14][15][16][17][18][19][20][21] These reports are Auto-SCT in children with AT/RT M Benesch et al summarized in Table 3. The number of patients included in these studies ranges from 3 to 32.…”

“…The number of patients included in these studies ranges from 3 to 32. 5,8,[14][15][16][17][18][19][20][21] In the larger series, a 2-year (event-free or overall) survival of up to 50% has been reported. 8,21 Recently, a retrospective, non-randomized Canadian study has demonstrated a statistically significant survival benefit in patients who had undergone HDCT.…”

High-Dose Chemotherapy/Stem Cell Transplantation (HDSCT)

“…The authors conclude that tandem HDCST has the ability to preserve reasonable outcomes in infants with malignant brain tumors with acceptable levels of long-term toxicities [ 39 ].…”

Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for High-Grade Gliomas in Children and Adolescents

“…HDCT/auto-SCT has also been used successfully in children with high-risk or recurrent brain tumors in children (131415). Recently, several studies have suggested that further dose-escalation using tandem HDCT/auto-SCT might improve outcomes for patients with recurrent or high-risk solid tumors including brain tumors (161718). In the present study, we reviewed retrospectively our experience with HDCT/auto-SCT for HGGs in children and adolescents to investigate the outcome and risk factors of the results after HDCT/auto-SCT.…”