Clinical results of high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation in children with advanced stage rhabdomyosarcoma

J Korean Med Sci. 2012 Sep;27(9):1066-72. doi: 10.3346/jkms.2012.27.9.1066. Epub 2012 Aug 22.

Abstract

Regardless of improvement in cure of Rhabdomyosarcoma (RMS), the results in treatment of advanced stage of RMS in children are still dismal. Recently, high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (HDC/APBSCT) has been tried to manage the advanced high-risk RMS patients. We investigated the effectiveness of HDC/APBSCT by reviewing the clinical records of high-risk pediatric RMS patients in single institute database. Over twenty years, 37 patients were diagnosed as RMS with high-risk at the time of first diagnosis. These patients were classified as two groups according to treatment method. The first group was HDC/APBSCT and the other was conventional multi-agent chemotherapy group. Differences of clinical results between the two groups were analyzed. The median age of patients was 5 yr, ranging from 6 months to 15 yr. The 5-yr event free survival rate (EFS) of all patients was 24.8% ± 4.8%. HDC/APBSCT group and conventional multi-agent chemotherapy group were 41.3% ± 17.8% and 16.7% ± 7.6% for 5-yr EFS, respectively (P = 0.023). There was a significant difference in the result of HDC/APBSCT between complete remission or very good partial response group and poor response group (50% ± 20.4% vs 37.5% ± 28.6%, P = 0.018). HDC/APBSCT can be a promising treatment modality in high-risk RMS patients.

Keywords: Bone Marrow Transplantation; Chemotherapy; Children; Rhabdomyosarcoma.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Ifosfamide / administration & dosage
  • Infant
  • Male
  • Peripheral Blood Stem Cell Transplantation*
  • Retrospective Studies
  • Rhabdomyosarcoma / drug therapy*
  • Rhabdomyosarcoma / mortality
  • Rhabdomyosarcoma / pathology
  • Survival Rate
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Etoposide
  • Carboplatin
  • Ifosfamide