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Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma
Author(s) -
Kadota Richard P.,
Mahoney Donald H.,
Doyle John,
Duerst Reggie,
Friedman Henry,
Holmes Emi,
Kun Larry,
Zhou Tianni,
Pollack Ian F.
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21655
Subject(s) - medicine , melphalan , medulloblastoma , cyclophosphamide , germinoma , busulfan , chemotherapy , oncology , hematopoietic stem cell transplantation , surgery , transplantation , pathology
Purpose To determine the response, toxicity, and survival for children with progressive or recurrent medulloblastoma and germinoma using a single myeloablative course of chemotherapy supported by autologous hematopoietic stem cells. Patients and Methods Subjects were in second remission or had minimal residual disease at the time of study entry. The conditioning regimen consisted of cyclophosphamide 6,000 mg/m 2 plus melphalan 180 mg/m 2 . Results Twenty‐nine evaluable pediatric patients were accrued. The most frequent major toxicities were myelosuppression, infections, and stomatitis, but no toxic deaths were recorded. Best responses were: CR = 6, CCR = 13, PR = 6, SD = 2, and PD = 2. There were 6 medulloblastoma and 3 germinoma survivors with a median follow‐up of 7.5 years (range = 2.8–10). Two germinoma survivors received radiotherapy after autografting for presumptive progressive disease. Conclusion Myeloablative chemotherapy consisting of cyclophosphamide and melphalan was tolerable in the relapsed brain tumor setting with 19/29 cases achieving CR or CCR status and 9/29 becoming long‐term survivors. Pediatr Blood Cancer 2008;51:675–678. © 2008 Wiley‐Liss, Inc.