Treatment of relapsed Wilms' tumor with high-dose therapy and autologous hematopoietic stem-cell rescue: The experience at children's memorial hospital

Andrew D. Campbell, Susan L. Cohn, Marleta Reynolds, Roopa Seshadri, Elaine Morgan, Grant Geissler, Alfred Rademaker, Maryann Marymount, John Kalapurakal, Paul R. Haut, Reggie Duerst, Morris Kletzel*

*Corresponding author for this work

Research output: Contribution to journalArticle

56 Scopus citations

Abstract

Purpose: To investigate whether high-dose therapy with hematopoietic stem-cell rescue (HSCR) will improve survival for patients with relapsed Wilms' tumor. Patients and Methods: Thirteen children with relapsed Wilms' tumor were treated with one or two cycles of high-dose chemotherapy (HDT) followed by autologous HSCR. Twelve of 13 patients received reinduction chemotherapy before HDT and HSCR. The median age at diagnosis was 4.8 years, and the median time to relapse was 12 months. The histology was favorable in 12 of 13 patients. The ablative regimens included: (1) thiotepa (TT)/cyclophosphamide (CTX)/carboplatin (CP; n = 2); (2) TT/CTX (n = 5); (3) TT/etoposide (ETP; n = 1); and (4) CP/ETP/CTX (n = 1). Four patients received two cycles of HDT and HSCR. Cycle 1 consisted of CP/ETP/CTX, and melphalan/CTX were used in cycle 2. Results: Seven of 13 patients are alive without evidence of disease, with a median follow-up of 30 months. The 4-year estimated event-free survival (EFS) rate is 60% (95% CI, 0.40 to 6.88), and the overall survival (OS) at 4 years is 73% (95% CI, 0.40 to 6.86). There was no transplant-related mortality. All patients engrafted to an absolute neutrophil count 500/μL at a median of 13 days (range, 8 to 62 days) and had an unsustained platelet count > 20.0μ at a median of 16 days (range, 10 to 202 days). Conclusion: Our results suggest that HDT with HSCR is an effective treatment for patients with Wilms' tumor who experience relapse.

Original languageEnglish (US)
Pages (from-to)2885-2890
Number of pages6
JournalJournal of Clinical Oncology
Volume22
Issue number14
DOIs
StatePublished - Dec 1 2004

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Treatment of relapsed Wilms' tumor with high-dose therapy and autologous hematopoietic stem-cell rescue: The experience at children's memorial hospital'. Together they form a unique fingerprint.

  • Cite this