Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Atypical Teratoid/Rhabdoid Tumor

Abstract

PurposeWe prospectively evaluated the effectiveness of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) in improving the survival of patients with atypical teratoid/rhabdoid tumors while reducing the risks of late adverse effects from radiotherapy (RT).Materials and MethodsFor young children (< 3 years old), tandem HDCT/auto-SCT was administered after six cycles of induction chemotherapy. RT was deferred until after 3 years of age unless the tumor showed relapse or progression. For older patients (> 3 years old), RT including reduced-dose craniospinal RT (23.4 or 30.6 Gy) was administered either after two cycles of induction chemotherapy or after surgery, and tandem HDCT/auto-SCT was administered after six cycles of induction chemotherapy.ResultsA total of 13 patients (five young and eight older) were enrolled from November 2004 to June 2012. Eight patients, including all five young patients, had metastatic disease at diagnosis. Six patients (four young and two older) experienced progression before initiation of RT, and seven were able to proceed to HDCT/auto-SCT without progression during induction treatment. Three of six patients who experienced progression during induction treatment underwent HDCT/auto-SCT as salvage treatment. All five young patients died from disease progression. However, four of the eight older patients remain progression-freewith a median follow-up period of 64 months (range, 39 to 108 months). Treatment-related late toxicities were acceptable.ConclusionThe required dose of craniospinal RT might be reduced in older patients if the intensity of chemotherapy is increased. However, early administration of RT should be considered to prevent early progression in young patients.

Protective Effects of Dihydromyricetin against •OH-Induced Mesenchymal Stem Cells Damage and Mechanistic Chemistry

“…For example, radiotherapy for cancer patients has been indicated to decrease cell survival in autologous stem cell transplantation [22]; Iron overload can yield the ‚OH radical through the Fenton reaction (Equation (1)) or Haber-Weiss (Equation (2)). In the present study, Fenton's reagent (FeCl 2 plus H 2 O 2 ) was used to damage MSCs, and then the MTT assay was firstly used to evaluate the beneficial effect of DHM on ‚OH radical-treated MSCs:…”

Sarcandra glabra (Caoshanhu) protects mesenchymal stem cells from oxidative stress: a bioevaluation and mechanistic chemistry

“…In fact, in autologous stem cell transplantation for cancer patients, radiotherapy has been recently indicated to decrease cell survival [7]. The most recent study pointed out that MSCs can even promote tumor recurrence after stereotactic body radiation therapy [8].…”

Atypical teratoid/rhabdoid tumors in children treated with multimodal therapies: The necessity of upfront radiotherapy after surgery

“…During CT, most patients experienced local recurrence with subsequent cerebrospinal fluid (CSF) dissemination. These patients were not salvaged with additional therapy, such as CSI . Therefore, the revised KSPNO protocol recommends that RT (including reduced‐dose CSI) should be administered before CT for patients 3 years and older, while local RT should be administered to those aged under 3 years.…”