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High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors.

Publication ,  Journal Article
Graham, ML; Herndon, JE; Casey, JR; Chaffee, S; Ciocci, GH; Krischer, JP; Kurtzberg, J; Laughlin, MJ; Longee, DC; Olson, JF; Paleologus, N ...
Published in: J Clin Oncol
May 1997

PURPOSE: We treated 49 patients with recurrent or poor-prognosis CNS malignancies with high-dose chemotherapy regimens followed by autologous marrow rescue with or without peripheral-blood stem-cell augmentation to determine the toxicity of and event-free survival after these regimens. PATIENTS AND METHODS: Nineteen patients had medulloblastomas, 12 had glial tumors, seven had pineoblastomas, five had ependymomas, three had primitive neuroectodermal tumors, two had germ cell tumors, and one had fibrosarcoma. Thirty-seven received chemotherapy with cyclophosphamide 1.5 g/m2 daily x 4 and melphalan 25 to 60 mg/m2 daily x 3. Nine received busulfan 37.5 mg/m2 every 6 hours x 16 and melphalan 180 mg/m2 (n = 7) or 140 mg/m2 (n = 2). Three received carboplatin 700 mg/m2/d on days -7, -5, and -3 and etoposide 500 mg/m2/d on days -6, -4, and -2. All patients received standard supportive care. RESULTS: Eighteen of 49 patients survive event-free 22+ to 55+ months (median, 33+) after transplantation, including nine of 16 treated before recurrence and nine of 33 treated after recurrence. There was one transplant-related death from pulmonary aspergillosis. Of five patients assessable for disease response, one had a partial remission (2 months), one has had stable disease (55+ months), and three showed progression 2, 5, and 8 months after transplantation. CONCLUSION: The toxicity of these regimens was tolerable. Certain patients with high-risk CNS malignancies may benefit from such a treatment approach. Subsequent trials should attempt to determine which patients are most likely to benefit from high-dose chemotherapy with autologous stem-cell rescue.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

May 1997

Volume

15

Issue

5

Start / End Page

1814 / 1823

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Pinealoma
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Melphalan
  • Medulloblastoma
  • Male
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Graham, M. L., Herndon, J. E., Casey, J. R., Chaffee, S., Ciocci, G. H., Krischer, J. P., … Friedman, H. S. (1997). High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors. J Clin Oncol, 15(5), 1814–1823. https://doi.org/10.1200/JCO.1997.15.5.1814
Graham, M. L., J. E. Herndon, J. R. Casey, S. Chaffee, G. H. Ciocci, J. P. Krischer, J. Kurtzberg, et al. “High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors.J Clin Oncol 15, no. 5 (May 1997): 1814–23. https://doi.org/10.1200/JCO.1997.15.5.1814.
Graham ML, Herndon JE, Casey JR, Chaffee S, Ciocci GH, Krischer JP, et al. High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors. J Clin Oncol. 1997 May;15(5):1814–23.
Graham, M. L., et al. “High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors.J Clin Oncol, vol. 15, no. 5, May 1997, pp. 1814–23. Pubmed, doi:10.1200/JCO.1997.15.5.1814.
Graham ML, Herndon JE, Casey JR, Chaffee S, Ciocci GH, Krischer JP, Kurtzberg J, Laughlin MJ, Longee DC, Olson JF, Paleologus N, Pennington CN, Friedman HS. High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors. J Clin Oncol. 1997 May;15(5):1814–1823.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

May 1997

Volume

15

Issue

5

Start / End Page

1814 / 1823

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Pinealoma
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Melphalan
  • Medulloblastoma
  • Male
  • Infant
  • Humans