TY - JOUR
T1 - Treatment of high-risk neuroblastoma with triple-tandem high-dose therapy and stem-cell rescue
T2 - Results of the Chicago Pilot II study
AU - Kletzel, Morris
AU - Katzenstein, Howard M.
AU - Haut, Paul R.
AU - Yu, Alice L.
AU - Morgan, Elaine
AU - Reynolds, Marleta
AU - Geissler, Grant
AU - Marymont, Maryanne H
AU - Liu, Dachao
AU - Kalapurakal, John A.
AU - Shore, Richard
AU - Bardo, Diana M.E.
AU - Schmoldt, Jennifer
AU - Rademaker, Alfred W.
AU - Cohn, Susan L.
PY - 2002/5/1
Y1 - 2002/5/1
N2 - Purpose: To investigate whether intensive induction therapy followed by triple-tandem cycles of high-dose therapy with peripheral-blood stem-cell rescue and local irradiation will improve event-free survival for patients with high-risk neuroblastoma. Patients and Methods: From August 1995 to January 2000, 25 consecutive newly diagnosed high-risk neuroblastoma patients and one child with recurrent MYCN-amplified disease were enrolled onto the Chicago Pilot II Protocol. After induction therapy and surgery, peripheral-blood stem cells were mobilized with three cycles of high-dose cyclophosphamide and granulocyte colony-stimulating factor. Patients then underwent triple-tandem cycles of high-dose therapy with peripheral-blood stem-cell rescue followed by radiation to the primary site. Results: Twenty-two of the 26 patients successfully completed induction therapy and were eligible for the triple-tandem consolidation high-dose therapy. Sufficient numbers of peripheral-blood stem cells were collected in all but one patient. Seventeen patients were able to complete all three cycles of high-dose therapy and peripheral-blood stem-cell rescue, two patients completed two cycles, and three patients completed one cycle. There was one toxic death, and one patient died from complications of treatment for graft failure. With a median follow-up of 38 months, the 3-year event-free survival and survival rates are 57% ± 11% and 79% ± 10%, respectively. Conclusion: 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.
AB - Purpose: To investigate whether intensive induction therapy followed by triple-tandem cycles of high-dose therapy with peripheral-blood stem-cell rescue and local irradiation will improve event-free survival for patients with high-risk neuroblastoma. Patients and Methods: From August 1995 to January 2000, 25 consecutive newly diagnosed high-risk neuroblastoma patients and one child with recurrent MYCN-amplified disease were enrolled onto the Chicago Pilot II Protocol. After induction therapy and surgery, peripheral-blood stem cells were mobilized with three cycles of high-dose cyclophosphamide and granulocyte colony-stimulating factor. Patients then underwent triple-tandem cycles of high-dose therapy with peripheral-blood stem-cell rescue followed by radiation to the primary site. Results: Twenty-two of the 26 patients successfully completed induction therapy and were eligible for the triple-tandem consolidation high-dose therapy. Sufficient numbers of peripheral-blood stem cells were collected in all but one patient. Seventeen patients were able to complete all three cycles of high-dose therapy and peripheral-blood stem-cell rescue, two patients completed two cycles, and three patients completed one cycle. There was one toxic death, and one patient died from complications of treatment for graft failure. With a median follow-up of 38 months, the 3-year event-free survival and survival rates are 57% ± 11% and 79% ± 10%, respectively. Conclusion: 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.
UR - http://www.scopus.com/inward/record.url?scp=0036569839&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036569839&partnerID=8YFLogxK
U2 - 10.1200/JCO.2002.06.060
DO - 10.1200/JCO.2002.06.060
M3 - Article
C2 - 11980999
AN - SCOPUS:0036569839
SN - 0732-183X
VL - 20
SP - 2284
EP - 2292
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 9
ER -