Treatment of High-Risk Neuroblastoma With Triple-Tandem High-Dose Therapy and Stem-Cell Rescue: Results of the Chicago Pilot II Study

Abstract

The results of this pilot study demonstrate that it is feasible to intensify consolidation with triple-tandem high-dose chemotherapy and peripheral-blood stem-cell rescue and local irradiation, and suggest that this treatment strategy may lead to improved survival for patients with high-risk neuroblastoma.

Tandem high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk neuroblastoma: Results of SMC NB-2004 study

“…Therefore, the duration of induction chemotherapy was longer in the present study than those in other studies concerning HDCT/auto-SCT for high-risk NB. [2][3][4][5][6] In addition, two different and relatively intensive regimens (CEDC and ICE) were alternated during induction treatment in order to overcome possible drug resistance and to reduce drug toxicities. As a result, the response rate to induction was better in the present study than in other cooperative protocols.…”

“…Tumor status before the first HDCT/auto-SCT was CR for 24 patients, VGPR for 13, PR for 11 and MR for 1. A median of 4.7 Â 10 6 CD34 þ cells/kg (range, 1.4-38.9) was collected during the first leukapheresis round with a median of five leukapheresis events (range, [3][4][5][6][7][8][9][10][11]. One patient underwent a second leukapheresis round to collect at least 2 Â 10 6 CD34 þ cells/kg.…”

“…Results suggest that further dose escalation might result in further improvements in the EFS of these patients. [5][6][7] We previously reported our experience on tandem HDCT/auto-SCT in patients with high-risk neuroblastoma. 7 Our retrospective analysis suggested that the EFS was encouraging despite a high TRM rate, particularly during the second HDCT/auto-SCT.…”

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

“…Sung et al 8,9 reported improved long-term survival using tandem HDCT/ASCR in patients with advanced neuroblastoma and high-risk brain tumors. Kletzel et al 10 also reported improved survival in a single-arm trial of triple-tandem HDCT/ASCR in patients with high-risk neuroblastoma. They demonstrated that further dose escalation using sequential HDCT/ASCR might result in additional improvements in the survival of patients with high-risk tumors.…”

“…[7][8][9][10] This treatment strategy is based on the hypothesis that a dose escalation might improve the survival of children with high-risk solid tumors. Recently, investigators have examined the efficacy of double or tripletandem HDCT/ASCR for further improvements in the outcome of patients with high-risk solid tumors.…”