Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
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Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation in Young Children with Atypical Teratoid/Rhabdoid Tumor of the Central Nervous System

  • Park, Eun Sil (Department of Pediatrics, Institute of Health Science, Gyeongsang National University School of Medicine) ;
  • Sung, Ki Woong (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Baek, Hee Jo (Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Park, Kyung Duk (Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine) ;
  • Park, Hyeon Jin (Center for Pediatric Oncology, National Cancer Center) ;
  • Won, Sung Chul (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Lim, Do Hoon (Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Heung Sik (Department of Pediatrics, Keimyung University School of Medicine)
  • Published : 2012.02.06
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Abstract

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% ${\pm}$ 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.

Keywords

References

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