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High-dose chemotherapy with autologous stem cell support in an adult with bone marrow relapse of medulloblastoma

Bone Marrow Transplantation volume 26, page 1029 (2000)Cite this article

Millot et al1 recently reported the effectiveness of treatment strategies including chemotherapy with etoposide and carboplatin followed by high-dose chemotherapy with peripheral blood stem cell transplantation in two adults with recurrent extraneuronal medulloblastoma (patients still in complete remission 20 and 27 months after treatment). We describe a case of an adult with medulloblastoma treated with the same regimen for bone and bone marrow metastasis involvement.

In 1996, a 33-year-old man received surgery and cranio-spinal irradiation for a localized cerebellar medulloblastoma. Thirty-six months later, in April 1999, he developed a pancytopenia due to bone marrow involvement, and bone metastases, without relapse in the central nervous system. Etopside 100 mg/m2 once daily i.v. and carboplatin 160 mg/m2 once daily i.v. for 5 consecutive days, every 4 weeks, resulted in a complete clinical and biological response after two cycles. Five cycles were given. There was only one episode of febrile neutropenia. We collected 3.39 × 104 CFU-GM/kg by cytapheresis after the fifth cycle and G-CSF stimulation. High-dose chemotherapy (HDC) included busulfan 4 mg/kg p.o. daily on days 1 to 4 and thiotepa 300 mg/m2 daily i.v. on days 5 to 8, followed by infusion of autologous peripheral hematopoietic stem cells. Neutropenia (less than 0.5 × 109/l) and thrombopenia (less than 50 × 109/l) lasted 11 days and 14 days respectively. Grade 4 mucositis necessitated morphine hydrochloride (30 mg/day) and parenteral nutrition for 7 days. The patient left the hospital 20 days after the stem cell transplant. Tumor response was assessed by spinal and cerebral magnetic resonance imaging, bone marrow aspiration and complete blood count. The patient is still in complete response 6 months after HDC.

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  1. Department of Medical Oncology, Centre Antoine-Lacassagne, 33, Avenue de Valombrose, Nice, Cedex 2, 06189, France

    C Foa, N Magné, J Otto & A Thyss

  2. Department of Radiotherapy, Centre Antoine-Lacassagne, 33, Avenue de Valombrose, Nice, Cedex 2, 06189, France

    P-Y Bondiau

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  1. C Foa
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  2. N Magné
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Foa, C., Magné, N., Bondiau, PY. et al. High-dose chemotherapy with autologous stem cell support in an adult with bone marrow relapse of medulloblastoma. Bone Marrow Transplant 26, 1029 (2000). https://doi.org/10.1038/sj.bmt.1702630

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