Outcome of high‐risk neuroblastoma using a dose intensity approach: Improvement in initial but not in long‐term results

Abstract

High-dose cyclophosphamide and high-dose carboplatin are effective in the initial treatment of neuroblastoma; combined with surgery they produce some response in most patients. Nevertheless, the CR/VGPR rate reaches only 53%. Survival time has also been prolonged but most patients relapse with metastases.

Neuroblastoma in adolescents: genetic and clinical characterisation

“…In fact, the four cases with stage 1or stage 2 are alive and disease-free. By considering only the stage 4 cases, the 5-year OS is similar to our results in stage 4 patients older than 1 year (p=ns) [26], but the EFS is lower and will possibly worsen over time, taking into account the long-term recurrences in this age group described by other authors and the fact that one of our patients relapsed at 106 months after diagnosis.…”

“…Indeed, all the stage 4 patients received therapy according to modern standards [25], except radiotherapy, which was omitted in the 2 Spanish high-risk NB studies [26].…”

Stage 4 neuroblastoma: sequential hemi-body irradiation or high-dose chemotherapy plus autologous haemopoietic stem cell transplantation to consolidate primary treatment

“…Our experience can be added to the limited number of other papers comparing different consolidation strategies after a common induction phase, thus making the results of these strategies fully comparable. These studies evaluated megatherapy vs continuing intensive chemotherapy (Matthay et al, 1999), or maintenance chemotherapy (Berthold et al, 1990;Castel et al, 2001), or no treatment (Pritchard et al, 2005). Combined with the other experiences including megatherapy, they reliably support the conviction that this consolidation treatment modality offers an advantage in terms of survival probability (McCowage et al, 1995;Kushner et al, 2001;Frappaz et al, 2002;Kaneko et al, 2002;Kletzel et al, 2002;De Bernardi et al, 2003).…”

Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

“…[1][2][3][4][5][6][7][8][9][10][11] Features associated with an improved prognosis include younger age 5,7 and absence of bone marrow involvement at diagnosis, 12 early disease response 13 and a complete or near complete response following induction therapy. 6,7,10,14 A poorer prognosis has been associated with an elevated serum ferritin (4143 ng/ ml), 6 bone and BM metastasis, 6 detectable circulating NB cells at diagnosis, 15,16 persisting skeletal and BM disease at the end of induction therapy, 1,2 circulating NB cells in patients otherwise apparently disease-free 16 and high-level of NB contamination at marrow harvest.…”