Outcome for young children newly diagnosed with ependymoma, treated with intensive induction chemotherapy followed by myeloablative chemotherapy and autologous stem cell rescue

2007 ◽  
Vol 49 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Stergios Zacharoulis ◽  
Adam Levy ◽  
Susan N. Chi ◽  
Sharon Gardner ◽  
Marc Rosenblum ◽  
...  
Keyword(s):  
Stem Cell ◽  
Young Children ◽  
Induction Chemotherapy ◽  
Newly Diagnosed ◽  
Stem Cell Rescue ◽  
Myeloablative Chemotherapy ◽  
Autologous Stem Cell Rescue

Feasibility and Response to Induction Chemotherapy Intensified With High-Dose Methotrexate for Young Children With Newly Diagnosed High-Risk Disseminated Medulloblastoma

2004 ◽  
Vol 22 (24) ◽  
pp. 4881-4887 ◽  
Author(s):  
Susan N. Chi ◽  
Sharon L. Gardner ◽  
Adam S. Levy ◽  
Edmond A. Knopp ◽  
Douglas C. Miller ◽  
...  
Keyword(s):  
High Risk ◽  
Young Children ◽  
Induction Chemotherapy ◽  
Response Rate ◽  
Chemotherapy Regimen ◽  
High Response Rate ◽  
High Dose ◽  
Newly Diagnosed ◽  
Stem Cell Rescue ◽  
Myeloablative Chemotherapy

Purpose To evaluate the feasibility of and response rate to an intensified induction chemotherapy regimen for young children with newly diagnosed high-risk or disseminated medulloblastomas. Patients and Methods From January 1997 to March 2003, 21 patients with high-risk or disseminated medulloblastoma were enrolled. After maximal surgical resection, patients were treated with five cycles of vincristine (0.05 mg/kg/wk × three doses per cycle for three cycles), cisplatin (3.5 mg/kg per cycle), etoposide (4 mg/kg/d × 2 days per cycle), cyclophosphamide (65 mg/kg/d × 2 days per cycle) with mesna, and methotrexate (400 mg/kg per cycle) with leucovorin rescue. Following induction chemotherapy, eligible patients underwent a single myeloablative chemotherapy cycle with autologous stem-cell rescue. Results Significant toxicities of this intensified regimen, including gastrointestinal and infectious toxicities, are described. Among the 21 patients enrolled, there were 17 complete responses (81%), two partial responses, one stable disease, and one progressive disease. The 3-year event-free survival and overall survival are 49% (95% CI, 27% to 72%) and 60% (95% CI, 36% to 84%), respectively. Conclusion This intensified induction chemotherapy regimen is feasible and tolerable. With the majority of patients with disseminated medulloblastoma having M2 or M3 disease at diagnosis, the encouraging high response rate of this intensified induction regimen suggests that such an addition of methotrexate should be explored in future studies.

Intensive Methotrexate and Cytarabine Followed by High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Newly Diagnosed Primary CNS Lymphoma: An Intent-to-Treat Analysis

2003 ◽  
Vol 21 (22) ◽  
pp. 4151-4156 ◽  
Author(s):  
Lauren E. Abrey ◽  
Craig H. Moskowitz ◽  
Warren P. Mason ◽  
Michael Crump ◽  
Douglas Stewart ◽  
...  
Keyword(s):  
Stem Cell ◽  
Induction Chemotherapy ◽  
Primary Cns Lymphoma ◽  
High Dose Chemotherapy ◽  
Cns Lymphoma ◽  
High Dose ◽  
Newly Diagnosed ◽  
Stem Cell Rescue ◽  
Autologous Stem Cell Rescue

Purpose: To assess the safety and efficacy of intensive methotrexate-based chemotherapy followed by high-dose chemotherapy (HDT) with autologous stem-cell rescue in patients with newly diagnosed primary CNS lymphoma (PCNSL). Patients and Methods: Twenty-eight patients received induction chemotherapy using high-dose systemic methotrexate (3.5 g/m2) and cytarabine (3 g/m2 daily for 2 days). Fourteen patients with chemosensitive disease evident on neuroimaging then received high-dose therapy using carmustine, etoposide, cytarabine, and melphalan with autologous stem-cell rescue. Results: The objective response rate to the induction-phase chemotherapy was 57%, and median overall survival is not yet assessable, with a median follow-up time of 28 months. The overall median event-free survival time is 5.6 months for all patients and 9.3 months for 14 patients who underwent transplantation. Six of these 14 patients (43%) remained disease-free at last follow-up. Treatment was well tolerated; there was one transplantation-related death. Prospective neuropsychologic evaluations have revealed no evidence of treatment-related neurotoxicity. Conclusion: This treatment approach is feasible in patients with newly diagnosed PCNSL without evidence of significant related neurotoxicity. Although the transplantation results are similar to those achieved in patients with aggressive or poor-prognosis systemic lymphoma, the low response rate to induction chemotherapy and the significant number of patients who experienced relapse soon after HDT suggest that more aggressive induction chemotherapy may be warranted.

High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Children and Adults With Newly Diagnosed Pineoblastomas

2003 ◽  
Vol 21 (11) ◽  
pp. 2187-2191 ◽  
Author(s):  
Sridharan Gururangan ◽  
Colleen McLaughlin ◽  
Jennifer Quinn ◽  
Jeremy Rich ◽  
David Reardon ◽  
...  
Keyword(s):  
Stem Cell ◽  
Metastatic Disease ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
High Dose Chemotherapy ◽  
Pineal Region ◽  
High Dose ◽  
Newly Diagnosed ◽  
Stem Cell Rescue ◽  
Autologous Stem Cell Rescue

Purpose: We evaluated the usefulness of a treatment regimen that included high-dose chemotherapy (HDC) with autologous stem-cell rescue (ASCR) in patients with newly diagnosed pineoblastoma (PBL). Patients and Methods: Twelve patients with PBL were initially treated with surgery and induction chemotherapy. All but two patients underwent radiotherapy. Subsequently, all patients received HDC using cyclophosphamide (CTX) + melphalan (MEL) or busulfan (Bu) + MEL regimens and ASCR. Results: A total of six children and six adults with median ages of 4.2 (range, 0.3 to 19.8 years) and 23 years (range, 23 to 43.7 years), respectively, were treated according to this strategy. Four patients had metastatic disease confined to the neuraxis. Five of 12 patients (42%) had a complete tumor resection at diagnosis. Ten patients received radiotherapy at median doses of 36.0 and 59.4 Gy to the neuraxis and pineal region, respectively. Eleven patients received HDC with CTX + MEL, and one patient received BU + MEL followed by ASCR. Nine patients are alive with no evidence of disease recurrence at a median of 62 months from diagnosis (range, 28 to 125 months), including three patients with metastatic disease and two infants who did not receive any radiotherapy. Three patients have died of progressive disease at 19, 32, and 37 months from diagnosis, respectively. The actuarial 4-year progression-free and overall survivals are 69% (95% confidence interval [CI], 39% to 99%) and 71% (95% CI, 43% to 99%), respectively. Conclusion: The use of HDC in addition to radiotherapy seems to be an effective treatment for patients with newly diagnosed pineoblastoma.

Myeloablative Carboplatin and Thiotepa With Autologous Stem Cell Rescue for Nonmedulloblastoma High-risk CNS Tumors in Young Children

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Carol Fries ◽  
Angela R. Girvin ◽  
David N. Korones ◽  
Lauren Weintraub ◽  
Lorna Fitzpatrick ◽  
...  
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
Young Children ◽  
Cns Tumors ◽  
Stem Cell Rescue ◽  
Autologous Stem Cell Rescue

High-dose consolidation therapy with autologous stem cell rescue in stage IV breast cancer.

1989 ◽  
Vol 7 (12) ◽  
pp. 1824-1830 ◽  
Author(s):  
S F Williams ◽  
R Mick ◽  
R Desser ◽  
J Golick ◽  
J Beschorner ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Stem Cell ◽  
Induction Chemotherapy ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Complete Response ◽  
High Dose ◽  
Stem Cell Rescue ◽  
Stage Iv Breast Cancer ◽  
Autologous Stem Cell Rescue

We designed a phase II study to determine whether induction chemotherapy (CT) consisting of leucovorin, vincristine, methotrexate, doxorubicin, and cyclophosphamide (LOMAC) followed by high-dose intensification chemotherapy (ICT) with cyclophosphamide, thiotepa, and autologous stem cell rescue (ASCR) could increase the complete response (CR) rate and survival in women with stage IV breast cancer. Twenty-nine women were enrolled on study; 16 patients had received prior adjuvant chemotherapy and no patient had received chemotherapy for stage IV disease. Two patients were found to be ineligible and excluded from further analysis. Of the 27 patients treated, four (15%) obtained a CR and 15 (56%) a partial response (PR) after LOMAC induction, for an overall response rate of 70%. Of the 22 patients treated with ICT, 12 patients had a CR, and nine were in PR after induction and converted to CR after ICT. The toxicities included nausea/vomiting, mucositis, diarrhea, dermatitis, alopecia, and infections secondary to neutropenia. The 1-year survival is 60%; the median has not yet been reached. The time to treatment failure for patients on study is 10 months. The treatment approach of ICT and ASCR following induction chemotherapy can lead to an improved CR rate in stage IV breast cancer. How this increased CR rate leads to a prolonged disease-free survival requires further follow-up.

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