Skip to main content

Rapid Sequence Tandem Transplant in Children with High-Risk Neuroblastoma

  • Conference paper
Transplantation in Hematology and Oncology II

Abstract

The majority of patients with high risk neuroblastoma (NB) still relapse. We have designed a Phase II trial for children with advanced NB utilizing a program of induction chemotherapy followed by tandem high-dose, myeloablative treatments with stem cell rescue (HDT/SCR) in rapid sequence. The study has completed accrual and, in the most recent update of the data, 62 patients are evaluable. 107 cycles of HDT/ SCR have been completed. Pheresis has been possible for every case, despite the young age of these patients, with an average of 7.2 × 106 CD34+ cells/kg/cycle available. Engraftment has been rapid, with median time to neutrophil engraftment of 11 days. Seven patients who completed the first HDT course did not complete the second, and there were five toxic deaths. With a median follow-up of 24 months from diagnosis, the 3 year point estimate of EFS is 63%. Some of the patients received stem cells purged by CD34 selection and the engraftment and EFS of these patients are similar to the overall group. This work demonstrates that a tandem HDT/SCR regimen for highrisk NB is feasible in children and may improve disease-free survival.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Matthay KK, Villablanca JG, Seeger RC, Stram DO, Harris RE, Ramsay NK, Swift P, Shimada H, Black CT, Brodeur GM, Gerbing RB, Reynolds CP. Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cisretinoic acid. N Engl J Med. 1999;341:1165–1173

    Article  PubMed  CAS  Google Scholar 

  2. Broun ER, Sridhara R, Sledge GW, Loesch D, Kneebone PH, Hanna M, Hromas R, Cornetta K, Einhorn LH. Tandem autotransplantation for the treatment of metastatic breast cancer. J Clin Oncol. 1995;13:2050–2055

    PubMed  CAS  Google Scholar 

  3. Lotz JP, Bouleuc C, Andre T, Touboul E, Macovei C, Hannoun L, Lefranc JP, Houry S, Uzan S, Izrael V. Tandem high-dose chemotherapy with ifosfamide, carboplatin, and teniposide with autologous bone marrow transplantation for the treatment of poor prognosis common epithelial ovarian carcinoma. Cancer. 1996;77:2250–2259

    Article  Google Scholar 

  4. Cohn SL, Moss TJ, Hoover M, Katzenstein HM, Haut PR, Morgan ER, Green AA, Kletzel M. Treatment of poor-risk neuroblastoma patients with high-dose chemotherapy and autologous peripheral stem cell rescue. Bone Marrow Transplant. 1997;20:543–551

    Article  PubMed  CAS  Google Scholar 

  5. Haut PR, Cohn S, Morgan E, Hubbell M, Danner-Koptik K, Olszewski M, Schaff M, Kletzel M. Efficacy of autologous peripheral blood stem cell (PBSC) harvest and engraftment after ablative chemotherapy in pediatric patients. Biol Blood Marrow Transplant. 1998;4:38–42

    Article  PubMed  CAS  Google Scholar 

  6. Diaz MA, Villa M, Madero L, Benito A, Alegre A, Fernandez-Ranada JM. Analysis of engraftment kinetics in pediatric patients undergoing autologous PBPC transplantation. J Hematother. 1998;7:367–373

    Article  PubMed  CAS  Google Scholar 

  7. Brodeur GM, Pritchard J, Berthold F, Carlsen NLT, Castel V, Castleberry RP, De Bernardi B, Evans AE, Favrot M, Hedborg F, Kaneko M, Kemshead J, Lampert F, Lee REJ, Look AT, Pearson ADJ, Philip T, Roald B, Sawada T, Seeger RC, Tsuchida Y, Voute PA. Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment. J Clin Oncol. 1993;11:1466–1477

    PubMed  CAS  Google Scholar 

  8. Grupp SA, Stern JW, Bunin N, Nancarrow C, Ross AA, Mogul M, Adams R, Grier HE, Gorlin JB, Shamberger R, Marcus K, Neuberg D, Weinstein H J, Diller L. Tandem high dose therapy in rapid sequence for children with high-risk neuroblastoma. J Clin Onc. 2000;18:2567–2575

    CAS  Google Scholar 

  9. Shpall EJ, Jones RB, Bearman SI, Franklin WA, Archer PG, Curiel T, Bitter M, Claman HN, Stemmer SM, Purdy M, Myers SE, Hami L, Taffs S, Heimfeld S, Hallagan J, Berenson RJ. Transplantation of enriched CD34-positive autologous marrow into breast cancer patients following high-dose chemotherapy: influence of CD34-positive peripheral-blood progenitors and growth factors on engraftment. J Clin Oncol. 1994;12:28–36

    PubMed  CAS  Google Scholar 

  10. Donovan J, Temel J, Zuckerman A, Gribben J, Fang J, Pierson G, Ross A, Diller L, Grupp SA. CD34 selection as a stem cell purging strategy for neuroblastoma: pre-clinical and clinical studies. Med. Ped. Oncol. 2000;in press

    Google Scholar 

  11. Bearman SI, Anderson GL, Mori M, Hinds MS, Shulman HM, McDonald GB. Venoocclusive disease of the liver: development of a model for predicting fatal outcome after marrow transplantation. J Clin Oncol. 1993;11:1729–1736

    PubMed  CAS  Google Scholar 

  12. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481

    Article  Google Scholar 

  13. Matthay KK, Harris R, Reynolds CP, Shimada H, Black T, Stram DO, Seeger RC. Improved eventfree survival for autologous bone marrow transplantation vs chemotherapy in neuroblastoma: a Childrens Cancer Group study. Med Pediatr Oncol. 1998;31:191, O-197

    Google Scholar 

  14. Matthay KK. Impact of myeloablative therapy with bone marrow transplantation in advanced neuroblastoma. Bone Marrow Transplant. 1996;18:S21–24

    PubMed  Google Scholar 

  15. Kletzel M, Longino R, Danner K, Olszewski M, Moss T. Peripheral blood stem cell rescue in children with advanced stage neuroblastoma. Prog Clin Biol Res. 1994;389:513–519

    PubMed  CAS  Google Scholar 

  16. Kletzel M, Abella EM, Sandler ES, Williams LL, Ogden AK, Pollock BH, Wall DA. Thiotepa and cyclophosphamide with stem cell rescue for consolidation therapy for children with high-risk neuroblastoma: a phase I/II study of the Pediatric Blood and Marrow Transplant Consortium. J Pediatr Hematol Oncol. 1998;20:49–54

    Article  PubMed  CAS  Google Scholar 

  17. Handgretinger R, Greil J, Schurmann U, Lang P, Gonzalez-Ramella O, Schmidt I, Fuhrer R, Niethammer D, Klingebiel T. Positive selection and transplantation of peripheral CD34+ progenitor cells: feasibility and purging efficacy in pediatric patients with neuroblastoma. J Hematother. 1997;6:235–242

    Article  PubMed  CAS  Google Scholar 

  18. Kanold J, Yakouben K, Tchirkov A, Carret A-S, Vannier J-P, LeGall E, Bordigoni P, Demeocq F. Long-term results of CD34+ cell transplantation in children with neuroblastoma. Med Pediatr Oncol. 2000;35:1–7

    Article  PubMed  CAS  Google Scholar 

  19. Kanold J, Yakouben K, Tchirkov A, Halle P, Carret AS, Berger M, Rapatel C, deLumley L, Vannier JP, Plantaz D, LeGall E, Lutz P, Mechinaud F, Rialland X, Combaret V, Bordigoni P, Deméocq F. Long-term follow-up after CD34+ cell transplantation in children with neuroblastoma. Blood. 1998;92:445a (abstr 1842)

    Google Scholar 

  20. Philip T, Ladenstein R, Zucker JM, Pinkerton R, Bouffet E, Louis D, Siegert W, Bernard JL, Frappaz D, Coze C. Double megatherapy and autologous bone marrow transplantation for advanced neuroblastoma: the LMCE2 Study. Br J Cancer. 1993;67:119–127

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Grupp, S.A. et al. (2003). Rapid Sequence Tandem Transplant in Children with High-Risk Neuroblastoma. In: Berdel, W.E., Büchner, T., Kienast, J., Jürgens, H., Ritter, J., Vormoor, J. (eds) Transplantation in Hematology and Oncology II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55774-3_33

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-55774-3_33

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62660-9

  • Online ISBN: 978-3-642-55774-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics