Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma

Richard P. Kadota, Donald H. Mahoney, John Doyle, Reggie E Duerst, Henry Friedman, Emi Holmes, Larry Kun, Tianni Zhou, Ian F. Pollack

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Purpose. To determine the response, toxicity, and survival for children with progressive or recurrent medulloblastoma and germinoma using a single myeloablative course of chemotherapy supported by autologous hematopoietic stem cells. Patients and Methods. Subjects were in second remission or had minimal residual disease at the time of study entry. The conditioning regimen consisted of cyclophosphamide 6,000 mg/m2 plus melphalan 180 mg/m2. Results. Twenty-nine evaluable pediatric patients were accrued. The most frequent major toxicities were myelosuppression, infections, and stomatitis, but no toxic deaths were recorded. Best responses were: CR = 6, CCR = 13, PR = 6, SD = 2, and PD = 2. There were 6 medulloblastoma and 3 germinoma survivors with a median follow-up of 7.5 years (range = 2.8-10). Two germinoma survivors received radiotherapy after autografting for presumptive progressive disease. Conclusion. Myeloablative chemotherapy consisting of cyclophosphamide and melphalan was tolerable in the relapsed brain tumor setting with 19/29 cases achieving CR or CCR status and 9/29 becoming long-term survivors.

Original languageEnglish (US)
Pages (from-to)675-678
Number of pages4
JournalPediatric Blood and Cancer
Volume51
Issue number5
DOIs
StatePublished - Nov 2008

Keywords

  • Autograft
  • Chemotherapy
  • Germinoma
  • Medulloblastoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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