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ctt-journal > Belogurova et al. (Abstract)

Belogurova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract49

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

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The experience of chemotherapy with Topotecan in children with recurrent or refractory solid tumors

Margarita B. Belogurova1,2, Yulia V. Dinikina1,2, Galina G. Radulesku1,2, Ludmila I. Shats1,2, Tatiana D. Viktorovich1,2, Emilia D. Chavpetsova1Anna S. Kharitonova1,2

1City Clinical Hospital № 31, Department of pediatric oncology and hematology; 2Saint-Petersburg pediatric medical academy, Department of oncology with a course of radiodiagnostics and radiotherapy, St. Petersburg, Russia

Correspondence: Margarita B. Belogurova, City Clinical Hospital No. 31, 3, pr. Dinamo, St. Petersburg, 197110, Russia, E-mail: deton.hospital31@spam is badinbox.ru

Abstract

Introduction: Topotecan (Tp) is approved for adults with different types of malignant tumors; however it has not been sufficiently studied in children.

Purpose: To determine the response rate and toxicity of the combination of chemotherapy with Tp in pediatric pts with recurrent or refractory malignant solid tumors.

Materials and methods: Between 2005 and 2011 14 pediatric pts received Tp-containing second-line chemotherapy. Eight pts had relapse of neuroblastoma; 3, rhabdomyosarcoma; 1, malignant mesothelioma; 1, synovial sarcoma, and 1, a refractory form of embryonal RMS (ERMS). Their median age was 3.9 years. Chemotherapy with Tp was carried out according following schemes: Tp 1mg/m2+ Carboplatin 150 mg/m2 on days 1–4, Tp 1mg/m2+ Cyclophosphamide 250 mg/m2 days on 1–7, and monotherapy with Tp 1 mg/m2 on days 1–5. The number of courses varied from 1 to 5.

Results: Twenty-nine courses of chemotherapy with Tp were carried out in 14 pts. Complete and partial responses were seen in 3 pts with RMS, in 1 pt with synovial sarcoma and in 1 pt with mesothelioma of the peritoneum. A minimal response including reduced pain and bone marrow remission was seen in 4 pts with neuroblastoma. The toxicity of chemotherapy was limited principally to the hematopoietic system (51.7%), with grade 3–4 neutropenia, and grade 2–4 thrombocytopenia. Non-hematological complications included stomatitis (14.2%) and diarrhea (14.2%). Currently 1 patient with ERMS remains in complete remission during the 41st month, one patient receives second-line chemotherapy, and 12 have died due to disease progression.

Conclusions: Chemotherapy with Tp can be effective against RMS and neuroblastoma, and is associated with relatively low toxicity. However, we didn’t achieve a marked improvement of survival in this group of pts.

Keywords: Topotecan, children, relapse, rhabdomyosarcoma, neuroblastoma