Feasibility of a tandem autologous peripheral blood stem cell transplant regimen for high risk neuroblastoma in a cooperative group setting: A Pediatric Oncology Group study: A Report from the Children's Oncology Group

Meaghan Granger*, Stephan A. Grupp, Morris Kletzel, Cynthia Kretschmar, Arlene Naranjo, Wendy B. London, Lisa Diller

*Corresponding author for this work

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background: The Pediatric Oncology Group performed a pilot study to assess the feasibility of tandem high dose chemotherapy (HDC) with stem cell rescue (HDC/SCR). We report here the results of this single arm trial of induction chemotherapy, local control measures (surgery and local radiation), and tandem HDC/SCR. Procedure: Patients with high risk neuroblastoma (NBL) underwent five cycles of induction chemotherapy and resection of primary tumors. Peripheral blood stem cells (PBSC) were collected after Course 3 without exvivo manipulation. Myeloablative chemotherapy was performed in rapid sequence after induction chemotherapy and surgery. The ability of patients to complete both cycles of HDC/SCR was a primary endpoint. Transplant-related toxicity, progression-free survival (PFS) and overall survival (OS) were recorded. Results: A total of 33 patients were enrolled. Twenty-two patients completed at least one HDC/SCR procedure and 17 patients completed both. Only one patient had insufficient stem cells collected for both transplants. There was one transplant-related death; engraftment was rapid and toxicity was as expected. The PFS of the 33 patients treated on this study is 24.2%±7.5% and OS is 36.4%±8.4% at 5 years. For patients who received at least one transplant PFS is 36.4%±11.0% and OS is 45.5%±11.2% at 5 years. Conclusions: The treatment of high risk NBL with tandem HDC/SCR is feasible in terms of transplant-related mortality and the ability to collect adequate PBSC for two transplants. The outcomes from this intensified treatment have been used to design a Children's Oncology Group Phase III study testing the efficacy of tandem HDC/SCR.

Original languageEnglish (US)
Pages (from-to)902-907
Number of pages6
JournalPediatric Blood and Cancer
Volume59
Issue number5
DOIs
StatePublished - Nov 2012

Keywords

  • High risk neuroblastoma
  • Myeloablative therapy
  • POG 9640
  • Peripheral blood stem cell transplant
  • Tandem transplant

ASJC Scopus subject areas

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

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