Comprehensive treatment of advanced neuroblastoma involving autologous bone marrow transplant
| Autor: | Hiroyuki Shichino, Yoshiaki Tsuchida, Hideyuki Kito, Takashi Suzuki, Shoichi Koizumi, Morihiro Saeki, Junichi Mimaya, Isao Serine, Takahito Fujisawa, Atsushi Kikuta, Noboru Okada, Mutsuro Ohira, Motoaki Chin, Teruho Kajimoto, Masahiro Tanabe, Mitsumasa Iwata, Toshiaki Shimada, Kensuke Harada, Mayumi Takamura, Ikuo Okabe, Syunichi Kato, Jun-ichi Akatsuka, Ichiro Tsukimoto, Yoshiaki Tanaka, Masataka Ichikawa, Michio Kaneko, Jotaro Yokoyama, Takao Okamatsu, Takeo Fujimoto, Naomi Onuma, Hideo Mugishima, Eiichi Sanuki |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Male
Pathology medicine.medical_specialty medicine.medical_treatment Intraoperative radiation Adrenal Gland Neoplasms Transplantation Autologous Disease-Free Survival Neuroblastoma Japan Antineoplastic Combined Chemotherapy Protocols Humans Medicine Retroperitoneal Neoplasms Child Isotretinoin Survival rate Bone Marrow Transplantation Chemotherapy business.industry Infant Total body irradiation Autologous bone medicine.disease Combined Modality Therapy Confidence interval Surgery Bone transplantation Child Preschool Pediatrics Perinatology and Child Health Female business Whole-Body Irradiation |
| Zdroj: | Pediatrics International. 37:493-499 |
| ISSN: | 1328-8067 |
| DOI: | 10.1111/j.1442-200x.1995.tb03361.x |
| Popis: | Encouraging results are reported with high-dose chemotherapy and total body irradiation followed by autologous bone marrow transplantation in the treatment of advanced neuroblastoma. However, relapse remains a significant problem. We used high-dose chemotherapy, surgery, intraoperative radiation and an autologous bone marrow transplant treated in vitro to remove tumor cells followed by 13-cis-retinoic acid to treat 36 children with advanced neuroblastoma. This comprehensive treatment appears to improve the survival rate of patients with advanced neuroblastoma, including those with N-myc amplification and bony involvement. The disease-free survival rate was 66% (95% confidence interval, 49-84%) at 3 years. All patients who received 13-cis-retinoic acid developed cheilitis, but no bone marrow depression occurred in these patients. Five patients developed hemolytic uremic syndrome (HUS) post-transplant. This may have been related to the procedure used for total body irradiation. Patients who had their kidneys shielded during this procedure did not develop this syndrome. Patients who received local irradiation at the primary site showed no evidence of relapse in this region, indicating that such therapy may help to prevent a relapse. These data suggest a high rate of 3 year disease-free survival with this treatment strategy. The nonrandomized nature of the study and use of multiple modalities precludes analysis of the specific contribution of each. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text