1994 Fiscal Year Final Research Report Summary
Comprchensive Trealmant of Adranced Necroblastuma Involving Aulologous Bone Merrow Transplant
| Project/Area Number |
04454283
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Pediatrics
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| Research Institution | Nihon University |
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Principal Investigator |
MUGISHIMA Hideo Nihon University School of Medicine Assistant Professor, 医学部, 講師 (80183648)
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| Co-Investigator(Kenkyū-buntansha) |
SUZUKI Takashi Nihon University School of Medicine Fellow, 医学部, 助手
FUJISAWA Takahito Nihon University School of Medicine Fellow, 医学部, 助手 (90256842)
SANUKI Eiichi Nihon University School of Medicine Assistant Professor, 医学部, 講師 (50142500)
IWATA Mitsumasa Nihon University School of Medicine Assistant Professor, 医学部, 講師 (60160123)
OKABE Ikuo Nihon University School of Medicine Professor, 医学部, 教授 (20059017)
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| Project Period (FY) |
1992 – 1994
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| Keywords | Advanced Neuroblaslcma / Autologous Bone Marrow Transplant / Radio therapy / Hemolylic clremic / 13-cis retinoic acid / Hormonal Function / Trk-A / Shimada Classification |
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| Research Abstract |
Encouraging results are reported with high-dose chemotherapy and total body irradiation followed by autologous bone marrow transplantation in thetreatment of advanced neuroblastoma, however, relapse remains a significant problem.
We used high-dose chemotherapy, surgery, intraoperative radiation, an autologous bone marrow transplant treated in vitro to remove tumor cells followed by 13-cis-retinoic acid to treat 36 children with advanced neuroblastoma.
This comprehensive treatment appears to improve the survival rate of patients with advanced neuroblastoma, including those with N-myc amplification and bony involvement. The disease-free-survival rate was 66% (95% confidence interval, 49-84%) at 3 years. All patients who received 13-cis-retinoic acid developed cheilitis, but no bone marrow depression occurred in this series. Five patients developed hemolytic uremic syndrome (HUS) posttransplant. This might be related to the procedure used for total body irradiation. Patients whohad their kidneys shielded during this procedure did not develop this syndrome. Patients who received local irradiation at the primary site showed no evidence of relapse in this region, indicating that such therapy may help to prevent a relapse.
These data suggest a high rate of 3-year disease free survival with this treatment strategy. The non-randomized nature of the study and use of multiple modalities precludes analysis of the specific contribution of each.
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