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ctt-journal > Gevorgian et al. (Abstract)

Gevorgian et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract29

© 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

Preliminary Program

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Results of high-dose chemotherapy with autologous hematopoietic stem cell transplantation in the treatment of pediatric brain tumors

Asmik G. Gevorgian1, Elena V. Morozova1, Ilya V. Kazantsev1, Tatjana V. Youhta2, Svetlana A. Safonova2, Yury A. Punanov2, Boris V. Afanasyev1, Olga G. Zheludkova3

1R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, Saint- Petersburg, Russia; 2Federal State Institution N.N. Petrov Research Institute of Oncology, St. Petersburg, Russia; 3Federal Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia

Correspondence: Asmik G. Gevorgian, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint- Petersburg Pavlov State Medical University, 6/8, Tolstoy str., St. Petersburg, 197022, Russia, E-mail: asmikgevorgyan3@spam is badgmail.com

Abstract

Aim: Central nervous system (CNS) tumors are the second most common pediatric malignancies with an about 30% 5-year overall survival rate in high-risk group. The aim of this study was to assess the effectiveness of single or tandem high-dose chemotherapy (HDC) with autologous hematopoietic stem-cell transplantation (auto-HSCT) in this patient group.

Methods: From October 2006 to April 2011, 10 pediatric patients with high-risk medulloblastoma (N=6), supratentorial PNET (N=2), and germinoma (N=2) received HDC with auto-HSCT after induction chemotherapy and surgical treatment. At the moment of HDC 2 patients were in complete remission (CR), 4 patients were in partial remission (PR) and 4 patients had stable disease (SD). Patients with germinoma received single auto-HSCT, patients with medulloblastoma or supratentorial PNET received tandem auto-HSCT. The conditioning regimen in the case of single auto-HDCT consisted of cisplatin, etoposide, and ifosfamide. In tandem HDCT, a carboplatin and etoposide regimen +/- thiotepa was followed by a thiotepa and cyclophosphamide regimen. Bone marrow (n=4), peripheral blood stem cells (n=3) or both (n=3) were used for stem cell sources. The mean transplanted CD34+ cell dose was 5.27 x 106/kg (range, 1.0–8.9 x 106/kg).

Results: The median follow-up for living patients is 207 days (range, 79–990). All patients with SD at the moment of transplantation died due to progression. Patients with CR or PR are all currently in CR. The conditioning regimens used were characterized by reasonable toxicity. The median time to engraftment was 16 (range 12–30) and 17 (range 13–86) days after the first and second auto-HSCT respectively.

Conclusions: HDCT with auto-SCT in pediatric patients with high-risk CNS tumors is characterized by acceptable toxicity and may be a feasible option for patients in CR or PR after induction chemotherapy. It is ineffective as a salvage therapy in refractory patients.

Keywords: brain tumor, medulloblastoma, PNET, germinoma, high-dose chemotherapy, autologous hematopoietic stem cell transplantation