Pilot Study of Iodine-131–Metaiodobenzylguanidine in Combination With Myeloablative Chemotherapy and Autologous Stem-Cell Support for the Treatment of Neuroblastoma

2002 ◽  
Vol 20 (8) ◽  
pp. 2142-2149 ◽  
Author(s):  
Gregory A. Yanik ◽  
John E. Levine ◽  
Katherine K. Matthay ◽  
James C. Sisson ◽  
Barry L. Shulkin ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pilot Study ◽  
Neuroblastoma Cells ◽  
Complete Response ◽  
Novel Therapy ◽  
Peripheral Blood Stem Cells ◽  
Hematopoietic Stem ◽  
Stem Cell Rescue ◽  
Myeloablative Chemotherapy ◽  
Iodine 131

PURPOSE: The survival for children with relapsed or metastatic neuroblastoma remains poor. More effective regimens with acceptable toxicity are required to improve prognosis. Iodine-131–metaiodobenzylguanidine (131I-MIBG) selectively targets radiation to catecholamine-producing cells, including neuroblastoma cells. A pilot study was performed to examine the feasibility of a novel regimen combining 131I-MIBG and myeloablative chemotherapy with autologous stem-cell rescue. PATIENTS AND METHODS: Twelve patients with neuroblastoma were treated after relapse (five patients) or after induction therapy (seven patients). Eight patients had metastatic and four had localized disease at the time of therapy. All patients received 131I-MIBG 12 mCi/kg on day −21, followed by carboplatin (1,500 mg/m2), etoposide (800 mg/m2), and melphalan (210 mg/m2) administered from day −7 to day −4. Autologous peripheral-blood stem cells or bone marrow were infused on day 0. Engraftment, toxicity, and response rates were evaluated. RESULTS: The 131I-MIBG infusion and myeloablative chemotherapy were both well tolerated. Grade 2 to 3 oral mucositis was the predominant nonhematopoietic toxicity, occurring in all patients. The median times to neutrophil (≥ 0.5 × 103/μL) and platelet (≥ 20 × 103/μL) engraftment were 10 and 28 days, respectively. For the eight patients treated with metastatic disease, three achieved complete response and two had partial responses by day 100 after transplantation. CONCLUSION: Treatment with 131I-MIBG in combination with myeloablative chemotherapy and hematopoietic stem-cell rescue is feasible with acceptable toxicity. Future study is warranted to examine the efficacy of this novel therapy.

AHOD00P1, a Pilot Study of Re-Induction Chemotherapy with Ifosfamide, and Vinorelbine (IV) in Children with Refractory/Relapsed Hodgkin Disease.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2496-2496
Author(s):  
Tanya Trippett ◽  
Pedro De Alarcon ◽  
Wendy London ◽  
Richard Sposto ◽  
Allen Chen ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Pilot Study ◽  
Pediatric Patients ◽  
Complete Response ◽  
Hodgkin Disease ◽  
Hematopoietic Stem ◽  
Cd34 Cells ◽  
Induction Regimen ◽  
Grade 3

Abstract A COG Phase II pilot study was conducted to assess the efficacy of the novel re-induction regimen of ifosfamide/vinorelbine (IV) in pediatric patients with heavily pre-treated relapsed/refractory Hodgkin disease. The treatment regimen consisted of : Ifosfamide 3 gm/m2/d continuous 24-hr IV infusion on Days 1–4; MESNA 3 gm/m2/d continuous 24-hr IV infusion on Days 1–5; and vinorelbine 25 mg/m2/dose IV bolus on Days 1, 5. Filgrastim was administered on Day 6 of Cycle 1 at a dose of 5 μg/kg until ANC ≥ 1000/μl for 3 consecutive days or ≥ 10,000/μl for 1 day and on Day 6 of Cycle 2 at a dose of 10 μg/kg to continue daily until completion of peripheral stem cell mobilization. We report the results of the first phase of the study, that evaluated the re-induction regimen IV which was substantiated as an effective re-induction regimen based on acceptable toxicity profile, capacity to mobilize hematopoietic stem cells (CD34+), and response sufficient to allow subsequent stem-cell transplantation in a large fraction of patients. Twenty-nine patients were accrued on study; 12 male (41%), 17 female (59%); median age at time of enrollment was 16 (range 5–20 yrs). The protocol mandated two cycles of therapy, although some patients received an optional third cycle. This report is based on data from the first 2 cycles only. Twenty-five patients had complete toxicity data. The predominant toxicity was hematologic, specifically leukopenia/neutropenia. The frequencies of grade 3–4 hematologic toxicities included: anemia (62%), leukopenia (100%), neutropenia (95%), and thrombocytopenia (50%). Hypophosphatemia (3%), febrile neutropenia (34.9%) and infection with grade 3 or 4 neutropenia (21.6%), and neurotoxicity (3%), each occurred in a minority of patients. There were no toxic deaths. Harvest was attempted in 25 patients. At least 2.5 x 106 CD34+ cells/kg were collected in 19 (76%), and at least 5.0 x 106 were collected in 16 (64%). Complete response data were available for twenty-five patients. Seven patients attained a complete response (CR) and eleven a partial response (PR) (CR/PR rate 72%). IV was substantiated as an acceptable re-induction regimen for children with Hodgkin disease. It was effective, well tolerated, and allowed for collection of sufficient CD34+ cells to support peripheral stem cell transplantation. Based upon these findings, 35 additional patients will be accrued to more precisely establish the definitive response rate in pediatric patients. In addition, minimally pretreated patients will now be included, allowing assessment of response, toxicity and hematopoietic stem cells (CD34+) mobilization in minimally pre-treated patients as well as in the heavily pre-treated population.

scholarly journals High-Dose Chemotherapy with Autologous Hematopoietic Stem-Cell Rescue for Pediatric Brain Tumor Patients: A Single Institution Experience from UCLA

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Eduard H. Panosyan ◽  
Alan K. Ikeda ◽  
Vivian Y. Chang ◽  
Dan R. Laks ◽  
Charles L. Reeb ◽  
...  
Keyword(s):  
Stem Cell ◽  
Brain Tumors ◽  
Hematopoietic Stem Cell ◽  
Germ Cell Tumors ◽  
Pediatric Brain Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Hematopoietic Stem ◽  
Stem Cell Rescue ◽  
Pediatric Brain

Background. Dose-dependent response makes certain pediatric brain tumors appropriate targets for high-dose chemotherapy with autologous hematopoietic stem-cell rescue (HDCT-AHSCR).Methods. The clinical outcomes and toxicities were analyzed retrospectively for 18 consecutive patients ≤19 y/o treated with HDCT-AHSCR at UCLA (1999–2009).Results. Patients' median age was 2.3 years. Fourteen had primary and 4 recurrent tumors: 12 neural/embryonal (7 medulloblastomas, 4 primitive neuroectodermal tumors, and a pineoblastoma), 3 glial/mixed, and 3 germ cell tumors. Eight patients had initial gross-total and seven subtotal resections. HDCT mostly consisted of carboplatin and/or thiotepa ± etoposide (n=16). Nine patients underwent a single AHSCR and nine ≥3 tandems. Three-year progression-free and overall survival probabilities were 60.5% ± 16 and 69.3% ± 11.5. Ten patients with pre-AHSCR complete remissions were alive/disease-free, whereas 5 of 8 with measurable disease were deceased (median followup: 2.3 yrs). Nine of 13 survivors avoided radiation. Single AHSCR regimens had greater toxicity than ≥3 AHSCR (P<.01).Conclusion. HDCT-AHSCR has a definitive, though limited role for selected pediatric brain tumors with poor prognosis and pretransplant complete/partial remissions.

scholarly journals Therapeutic salivary monitoring of IV busulfan in patients undergoing hematopoietic stem cell transplantation: a pilot study

2017 ◽  
Vol 52 (10) ◽  
pp. 1384-1389 ◽  
Author(s):  
L M Bezinelli ◽  
F P Eduardo ◽  
D L C de Carvalho ◽  
C E dos Santos Ferreira ◽  
E V de Almeida ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pilot Study ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem

Total Skin Electron Beam and Non-Myeloablative Allogeneic Hematopoietic Stem-Cell Transplantation in Advanced Mycosis Fungoides and Sézary Syndrome

2010 ◽  
Vol 28 (14) ◽  
pp. 2365-2372 ◽  
Author(s):  
Madeleine Duvic ◽  
Michele Donato ◽  
Bouthaina Dabaja ◽  
Heather Richmond ◽  
Lotika Singh ◽  
...  
Keyword(s):  
Electron Beam ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Cell Lymphoma ◽  
Chronic Gvhd ◽  
Complete Response ◽  
Cutaneous T Cell Lymphoma ◽  
Hematopoietic Stem

Purpose Transformed mycosis fungoides (MF) and Sézary syndrome (SS) are currently incurable. We studied the safety and efficacy of total skin electron beam with allogeneic hematopoietic stem-cell transplantation (HSCT) in patients with cutaneous T-cell lymphoma (CTCL). Patients and Methods Nineteen patients with advanced CTCL (median age, 50 years; four prior therapies) underwent total skin electron beam radiation followed by allogeneic HSCT between July 2001 and July 2008. Sixteen patients were conditioned with fludarabine (125 mg/m2) and melphalan (140 mg/m2) plus thymoglobulin (for mismatched donors). Graft-versus-host disease (GVHD) prophylaxis was with tacrolimus/mini methotrexate. Results Eighteen patients experienced engraftment, and one died as a result of sepsis on day 16. Median time to recovery of absolute neutrophil count (ANC) was 12 days. Fifteen achieved full donor chimerism, 12 had acute GVHD, and 12 were treated for chronic GVHD. The overall intent-to-treat response was 68%, and the complete response rate was 58%. Four of six patients died in complete remission as a result of bacterial sepsis (n = 2), chronic GVHD and fungal infection (n = 1), or lung cancer (n = 1); only two died as a result of progressive disease. Eight experienced relapse in skin; five regained complete response with reduced immunosuppression or donor lymphocyte infusions. Eleven of 13 are currently in complete remissions, with median follow-up of 19 months (range, 1.3 to 8.3 years). Median overall survival has not been reached. Conclusion Total skin electron beam followed by allogeneic stem-cell transplantation merits additional evaluation for a selected group of patients with refractory, advanced, cutaneous T-cell lymphoma with evidence for graft-versus-tumor effect.

scholarly journals MBCL-50. SAFETY AND EFFICACY OF CHEMOTHERAPY INTENSIFICATION WITH AUTOLOGOUS HEMATOPOIETIC STEM CELL RESCUE, WITHOUT RADIATION, FOR CHILDREN WITH CNS EMBRYONAL TUMORS

2018 ◽  
Vol 20 (suppl_2) ◽  
pp. i128-i128
Author(s):  
Abhishek Bavle ◽  
Naina Gross ◽  
Theresa Gavula ◽  
Michael Confer ◽  
Jo Elle Peterson ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Embryonal Tumors ◽  
Hematopoietic Stem ◽  
Safety And Efficacy ◽  
Stem Cell Rescue
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