PURPOSE: To investigate whether high-dose therapy with hematopoietic stem-cell rescue (HSCR) will improve survival for patients with relapsed Wilms' tumor. PATIENTS AND METHODS: Thirteen children with relapsed Wilms' tumor were treated with one or two cycles of high-dose chemotherapy (HDT) followed by autologous HSCR. Twelve of 13 patients received reinduction chemotherapy before HDT and HSCR. The median age at diagnosis was 4.8 years, and the median time to relapse was 12 months. The histology was favorable in 12 of 13 patients. The ablative regimens included: (1) thiotepa (TT)/cyclophosphamide (CTX)/carboplatin (CP; n = 2); (2) TT/CTX (n = 5); (3) TT/etoposide (ETP; n = 1); and (4) CP/ETP/CTX (n = 1). Four patients received two cycles of HDT and HSCR. Cycle 1 consisted of CP/ETP/CTX, and melphalan/CTX were used in cycle 2. RESULTS: Seven of 13 patients are alive without evidence of disease, with a median follow-up of 30 months. The 4-year estimated event-free survival (EFS) rate is 60% (95% CI, 0.40 to 6.88), and the overall survival (OS) at 4 years is 73% (95% CI, 0.40 to 6.86). There was no transplant-related mortality. All patients engrafted to an absolute neutrophil count 500/microL at a median of 13 days (range, 8 to 62 days) and had an unsustained platelet count > 20.0 micro at a median of 16 days (range, 10 to 202 days). CONCLUSION: Our results suggest that HDT with HSCR is an effective treatment for patients with Wilms' tumor who experience relapse.
PURPOSE: To investigate whether high-dose therapy with hematopoietic stem-cell rescue (HSCR) will improve survival for patients with relapsed Wilms' tumor. PATIENTS AND METHODS: Thirteen children with relapsed Wilms' tumor were treated with one or two cycles of high-dose chemotherapy (HDT) followed by autologous HSCR. Twelve of 13 patients received reinduction chemotherapy before HDT and HSCR. The median age at diagnosis was 4.8 years, and the median time to relapse was 12 months. The histology was favorable in 12 of 13 patients. The ablative regimens included: (1) thiotepa (TT)/cyclophosphamide (CTX)/carboplatin (CP; n = 2); (2) TT/CTX (n = 5); (3) TT/etoposide (ETP; n = 1); and (4) CP/ETP/CTX (n = 1). Four patients received two cycles of HDT and HSCR. Cycle 1 consisted of CP/ETP/CTX, and melphalan/CTX were used in cycle 2. RESULTS: Seven of 13 patients are alive without evidence of disease, with a median follow-up of 30 months. The 4-year estimated event-free survival (EFS) rate is 60% (95% CI, 0.40 to 6.88), and the overall survival (OS) at 4 years is 73% (95% CI, 0.40 to 6.86). There was no transplant-related mortality. All patients engrafted to an absolute neutrophil count 500/microL at a median of 13 days (range, 8 to 62 days) and had an unsustained platelet count > 20.0 micro at a median of 16 days (range, 10 to 202 days). CONCLUSION: Our results suggest that HDT with HSCR is an effective treatment for patients with Wilms' tumor who experience relapse.
Authors: Sue C Kaste; Jeffrey S Dome; Paul S Babyn; Norbert M Graf; Paul Grundy; Jan Godzinski; Gill A Levitt; Helen Jenkinson Journal: Pediatr Radiol Date: 2007-11-17
Authors: Jeffrey S Dome; Norbert Graf; James I Geller; Conrad V Fernandez; Elizabeth A Mullen; Filippo Spreafico; Marry Van den Heuvel-Eibrink; Kathy Pritchard-Jones Journal: J Clin Oncol Date: 2015-08-24 Impact factor: 44.544
Authors: Naomi Pode-Shakked; Rachel Shukrun; Michal Mark-Danieli; Peter Tsvetkov; Sarit Bahar; Sara Pri-Chen; Ronald S Goldstein; Eithan Rom-Gross; Yoram Mor; Edward Fridman; Karen Meir; Amos Simon; Marcus Magister; Naftali Kaminski; Victor S Goldmacher; Orit Harari-Steinberg; Benjamin Dekel Journal: EMBO Mol Med Date: 2012-12-13 Impact factor: 12.137
Authors: Hemant B Tongaonkar; Sajid S Qureshi; Purna A Kurkure; Mary-Ann A Muckaden; Brijesh Arora; Thyavihalli B Yuvaraja Journal: Indian J Urol Date: 2007-10