Myeloablative therapy with autologous stem cell rescue for patients with Ewing sarcoma

• Published in: Bone marrow transplantation (Basingstoke) Vol. 41; no. 10; pp. 867 - 872
• Main Authors: Gardner, S L, Carreras, J, Boudreau, C, Camitta, B M, Adams, R H, Chen, A R, Davies, S M, Edwards, J R, Grovas, A C, Hale, G A, Lazarus, H M, Arora, M, Stiff, P J, Eapen, M
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2008; Nature Publishing Group
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Autografts; Biological and medical sciences; Bone marrow; Bone marrow, stem cells transplantation. Graft versus host reaction; Care and treatment; Cell Biology; Chemotherapy; Child; Clinical trials; Combined Modality Therapy; Diagnosis; Disease Progression; Diseases of the osteoarticular system; Ewing's sarcoma; Ewings sarcoma; Female; Health risks; Hematology; Humans; Internal Medicine; Irradiation; Male; Medical sciences; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Myeloablative Agonists - therapeutic use; original-article; Patient outcomes; Patients; Public Health; Risk analysis; Risk Factors; Risk groups; Sarcoma; Sarcoma, Ewing - mortality; Sarcoma, Ewing - secondary; Sarcoma, Ewing - therapy; Statistical analysis; Stem cell transplantation; Stem Cell Transplantation - methods; Stem Cells; Survival Analysis; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Autologous; Tumors of striated muscle and skeleton; United States; PFS; Ewing sarcoma; autologous transplant; Human; Hematology; Stem cell; Diseases of the osteoarticular system; Hematopoietic cell; Malignant tumor; Autograft; Treatment; Graft; Myelosuppression; Cancer
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2008.2

The aim of this study was to identify risk factors associated with PFS in patients with Ewing sarcoma undergoing ASCT; 116 patients underwent ASCT in 1989–2000 and reported to the Center for International Blood and Marrow Transplant Research. Eighty patients (69%) received ASCT as first-line therapy and 36 (31%), for recurrent disease. Risk factors affecting ASCT were analyzed with use of the Cox regression method. Metastatic disease at diagnosis, recurrence prior to ASCT and performance score <90 were associated with higher rates of disease recurrence/progression. Five-year probabilities of PFS in patients with localized and metastatic disease at diagnosis who received ASCT as first-line therapy were 49% (95% CI 30–69) and 34% (95% CI 22–47) respectively. The 5-year probability of PFS in patients with localized disease at diagnosis, and received ASCT after recurrence was 14% (95% CI 3–30). PFS rates after ASCT are comparable to published rates in patients with similar disease characteristics treated with conventional chemotherapy, surgery and irradiation suggesting a limited role for ASCT in these patients. Therefore, ASCT if considered should be for high-risk patients in the setting of carefully controlled clinical trials.