Treatment of High-Risk Neuroblastoma

Хижников, А.В.; Казанцев, А. П.

doi:10.15690/onco.v4i2.1707

Cited by 5 publications

(3 citation statements)

References 20 publications

(22 reference statements)

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“…Учитывая также данные рандомизированного исследования SIOPEN, свидетельствующие о преимуществе режимов кондиционирования на основе бусульфана по сравнению с режимами кондиционирования на основе препаратов платины [27], можно рекомендовать данный режим в качестве одного из стандартов ВДПХТ. В качестве альтернативы бусульфану можно рассматривать треосульфан, эффективность которого продемонстрирована в крупных когортах больных [11,12]. К его преимуществам можно также отнести потенциально меньшую токсичность у пациентов, получивших терапию высокими дозами 131 I-МЙБГ или лучевую терапию.…”

Section: Discussionunclassified

“…Таким образом, своевременное проведение процедуры ВДПХТ с ауто-ТГСК может рассматриваться как один из факторов, позволяющих повысить эффективность лечения пациентов с НБ группы высокого риска. В Российской Федерации существует успешный опыт использования данного метода отдельными клиническими группами [11][12][13]. В настоящем исследовании проанализирован опыт применения ВДПХТ с ауто-ТГСК в клинике НИИ ДОГиТ им.…”

Section: актуальностьunclassified

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High-dose chemotherapy with autologous hematopoietic stem cell transplantation in high-risk neuroblastoma patients: Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, First Pavlov State Medical University of St. Petersburg experience

Казанцев¹,

Геворгян²,

Юхта³

et al. 2019

Ross. ž. det. gematol. onkol.

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Introduction.Neuroblastoma (NB) is the most common extracranial pediatric solid tumor. The high-risk group patients are characterized by adverse prognosis and require intensive complex therapy including high-dose chemotherapy (HDCT) with hematopoietic stem cell transplantation (auto-HSCT). The current study presents a single center experience of HSCT with auto-HSCT for high-risk NB performed in Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, First Pavlov State Medical University of St. Petersburg, Ministry of Health of Russia.Patients and methods.A cohort of 72 consecutive high-risk NB patients was included in the study. Among them 69 patients received Bu-Mel conditioning regimen (busulfan 16 mg/kg, melphalan 140 mg/m2 ), in 3 patients the 5D/5D regimen was used (carboplatin 1000 mg/m2 , irinotecan 150 mg/m2 , temozolomide 750 mg/m2 , etoposide 400 mg/m2 , cyclophosphamide 140 mg/kg). In most cases the autologous hematopoietic stem cells source was bone marrow (BM) (n = 59; 82 %), peripheral blood stem cells (PBSC) (n = 11; 15 %), or BM and PBSC (n = 2; 3 %). In 52/66 (79 %) patients with initial bone marrow involvement the potential transplant contamination was assessed by flow cytometry.Results.The 2-year and 5-year overall (OS) and event-free (EFS) survival was 61 % and 48 %, 41 % and 35 % accordingly. The main adverse factors for OS and EFS were age of more than 18 months at diagnosis, combined bone marrow and bones involvement, MYCN amplification, initial neuron-specific enolase level of more than 100 ng/ml, primary resistance or relapse, and metaiodobenzylguanidinepositive lesions persistence prior to or after HSCT with auto-HSCT.Conclusions.The results achieved are comparable to those described for similar cohorts. Some patient subgroups are unlikely to achieve response after HSCT with auto-HSCT. Therefore, additional stratification methods and treatment modalities are needed.Conflict of interest. The authors declare no conflict of interest.Funding. The study was performed without external funding.

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Section: Discussionunclassified

Section: актуальностьunclassified

High-dose chemotherapy with autologous hematopoietic stem cell transplantation in high-risk neuroblastoma patients: Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, First Pavlov State Medical University of St. Petersburg experience

Казанцев¹,

Геворгян²,

Юхта³

et al. 2019

Ross. ž. det. gematol. onkol.

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“…Гуморальный иммунный ответ в виде продукции антител к GD2 в естественных условиях не развивается, поскольку дисиалоганглиозид является аутоантигеном. Введение в организм пациента искусственно созданных моноклональных антител, чаще всего химерных, содержащих фрагменты человеческих и мышиных иммуноглобулинов, вызывает развитие реакции антителозависимой клеточной цитотоксичности [6,15]. Антитела связывают антиген GD2 на мембране клеток НБ и активируют клетки, экспрессирующие рецепторы к константному фрагменту иммуноглобулинов (в первую очередь NK-клетки и макрофаги).…”

Section: результатыunclassified

Passive immunotherapy experience in patients with high-risk neuroblastoma

Фасеева

Кулева

Иванова

et al. 2020

Ross. ž. det. gematol. onkol.

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The complex intensive therapy regimen as curative therapy in patients with primary-resistant and relapsed neuroblastoma: R.M. Gorbacheva Memorial Institute for Children Oncology, Hematology and Transplantation experience

Казанцев

Геворгян

Юхта

et al. 2020

Voprosy gematologii/onkologii i immunopatologii v pediatrii

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About 20% of initially high-risk patients with neuroblastoma (NB) develop primary resistant to chemotherapy and more than 50% of them subsequently have a relapse. There is currently no uniform approach to therapy in this group and long-term outcomes are dismal. The study was approved by the Independent Ethics Committee and the Scientific Council of the I.P. Pavlov First Saint Petersburg State Medical University. A total of 78 patients with a median age of 5 (1–20) years with primary resistant (n = 33) or (n = 45) relapsed NB receiving treatment in R.M. Gorbacheva Memorial Center were included in this study. In 20 cases the 2nd-line therapy including topotecan (n = 10) or irinotecan (n = 10) was used, 58 patients received combined chemo- and targeted therapy (RIST regimen: rapamycin, irinotecan, sirolimus, temozolomide). Nineteen patients with primary resistant disease (n = 4) or systemic relapse (n = 15) subsequently underwent an allogeneic hemopoietic stem cell transplantation from haploidentical donor (haplo-HSCT). In all cases fludarabin-based reduced intensity conditioning (RIC) regimens were used. Ten patents received modified graft (immunomagnetic selection or depletion), in 9 unmodified graft with subsequent post-transplant cyclophosphamide (PTCM) was used. Also, 16 of 19 haplo-HSCT recipients had post-transplant therapy. The clinical effect was seen in 79% of patients. The median event-free survival (EFS) in 2nd-line therapy and RIST recipients was 2.5 (1–11) and 8 (1–76) months, accordingly. The complete of good partial response in 2nd-line therapy or RIST recipients was seen in 5% and 15%, 14% and 31% of cases accordingly. The therapy toxicity was comparable in both groups. The median EFS for haplo-HSCT recipients was 15 months with 2-year OS and EFS in this group bring 44% and 21% accordingly. Seven of 19 (37%) patients are currently alive and 4 (21%) of 19 maintain response. All long-term responders have history of posttransplant therapy. There was no statistically significant difference based on graft-versus-host disease prophylaxis used (graft modification or PTCM) or KIR compatibility. Combined chemo- and targeted therapy (RIST) is characterized by acceptable toxicity and effective even in some previously resistant cases. In 20% of responders a long-term effect may be achieved by subsequent haplo-HSCT and post-transplant therapy.

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Treatment of High-Risk Neuroblastoma

Cited by 5 publications

References 20 publications

High-dose chemotherapy with autologous hematopoietic stem cell transplantation in high-risk neuroblastoma patients: Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, First Pavlov State Medical University of St. Petersburg experience

High-dose chemotherapy with autologous hematopoietic stem cell transplantation in high-risk neuroblastoma patients: Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, First Pavlov State Medical University of St. Petersburg experience

Passive immunotherapy experience in patients with high-risk neuroblastoma

The complex intensive therapy regimen as curative therapy in patients with primary-resistant and relapsed neuroblastoma: R.M. Gorbacheva Memorial Institute for Children Oncology, Hematology and Transplantation experience

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