Tandem high-dose chemotherapy and autologous stem cell transplantation in young children with atypical teratoid/rhabdoid tumor of the central nervous system

• Published in: Journal of Korean medical science Vol. 27; no. 2; pp. 135 - 140
• Main Authors: Park, Eun Sil, Sung, Ki Woong, Baek, Hee Jo, Park, Kyung Duk, Park, Hyeon Jin, Won, Sung Chul, Lim, Do Hoon, Kim, Heung Sik
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.02.2012; 대한의학회
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Central Nervous System Neoplasms - drug therapy; Central Nervous System Neoplasms - radiotherapy; Central Nervous System Neoplasms - therapy; Child, Preschool; Combined Modality Therapy; Cyclophosphamide - administration & dosage; Etoposide - administration & dosage; Female; Follow-Up Studies; Humans; Induction Chemotherapy; Infant; Male; Original; Prospective Studies; Recurrence; Rhabdoid Tumor - drug therapy; Rhabdoid Tumor - radiotherapy; Rhabdoid Tumor - therapy; Salvage Therapy; Stem Cell Transplantation; Survival Rate; Thiotepa - administration & dosage; Transplantation, Autologous; 의학일반; Stem Cell Transplantation; Central Nervous System; Radiotherapy; Rhabdoid Tumor; Child; Drug Therapy
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2012.27.2.135

The feasibility and effectiveness of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) were evaluated in children younger than 3 yr of age with atypical teratoid/rhabdoid tumors (ATRT). Tandem HDCT/autoSCT was administered following six cycles of induction chemotherapy. Radiotherapy (RT) was administered if the tumor relapsed or progressed, otherwise, it was administered after 3 yr of age. Tumors relapsed or progressed during induction chemotherapy in 5 of 9 patients enrolled; 3 of these 5 received tandem HDCT/autoSCT as a salvage treatment. One patient died from sepsis during induction chemotherapy. The remaining 3 patients proceeded to tandem HDCT/autoSCT; however, 2 of these patients showed tumor relapse/progression after tandem HDCT/autoSCT. All 7 relapses/progressions occurred at primary sites even in patients with leptomeningeal seeding. Toxicities during tandem HDCT/autoSCT were manageable. A total of 5 patients were alive with a median follow-up of 20 (range 16-70) months from diagnosis. Four of 5 patients who received RT after relapse/progression are alive. The probability of overall survival at 3 yr from diagnosis was 53.3% ± 17.3%. Our tandem HDCT/autoSCT is feasible; however, early administration of RT prior to tandem HDCT/autoSCT should be considered to improve the outcome after tandem HDCT/autoSCT.