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Efficacy and safety of high-dose chemotherapy with COG regimen combined with serial autologous hematopoietic stem cell transplantation in the treatment of high-risk neuroblastoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 09
Page:
1694-1698
Research Field:
Publishing date:

Info

Title:
Efficacy and safety of high-dose chemotherapy with COG regimen combined with serial autologous hematopoietic stem cell transplantation in the treatment of high-risk neuroblastoma
Author(s):
CHENG Jie; CHEN Tianping; GAO Shan; LU Youjia; LIU Yetian; QU Lijun; WANG Jian; LIU Hongjun
Department of Hematology and Oncology,Anhui Provincial Children's Hospital(Anhui Hospital,Pediatric Hospital of Fudan University),Anhui Hefei 230051，China.
Keywords:
high-risk neuroblastoma; high-dose chemotherapy; preconditioning regimen; autologous hematopoietic stem cell transplantation; tandem transplantation
PACS:
R739.4
DOI:
10.3969/j.issn.1672-4992.2024.09.021
Abstract:
Objective:To investigate the safety and efficacy of high-dose chemotherapy(HDC) based preconditioning combined with tandem autologous hematopoietic stem cell transplantation(ASCT) in the treatment of high-risk neuroblastoma(NB) in children according to the regimen of North American Children's Oncology Group(COG).Methods:This study included in 9 children with high-risk NB treated with ASCT in our department from July 2022 to June 2023,all of whom were treated according to COG high-risk NB autologous transplantation protocol.The first transplantation received high-dose thiotepa(TT) combined with cyclophosphamide（CTX） followed by ASCT.High-dose melphalan(Mel) and carboplatin(CBP) combined with etoposide(VP16) regimen(CEM regimen) was administered in the second transplantation pretreatment.Hematopoietic reconstruction,complications and efficacy were observed and evaluated after transplantation.Results:All the 9 cases were boys,and most of them were accompanied by multiple bone metastases,including 8 cases in stage Ⅳ and 1 case in stage Ⅲ,8 patients had at least two kinds of molecular genetic abnormalities except one who didn't receive the examination for some reason.The extramedullary side effects after the first conditioning regimen were mainly oral mucositis,diarrhea,and vomiting.The mean time of neutrophil implantation was 10.44 days,and the median time of platelet implantation was 15 days.There was no significant statistical difference in the rate of implantation and the degree of adverse reactions between the patients receiving the second tandem transplantation and the first transplantation in the same group.The median follow-up time was 330 days,and the PFS was 100% to the end of the observation period,and the disease evaluation was better than that before transplantation.Conclusion:COG protocol HDC combined with ASCT in the treatment of high-risk NB in children is safety.Better clinical efficacy was observed after double transplantation than after single transplantation.It is still necessary to expand the sample size and extend the observation time to determine the long-term efficacy of this treatment strategy.

References:

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Memo

Memo:
安徽省自然科学基金项目(编号：2108085MH268）
Last Update: 2024-03-29