Abstract
In this report, we describe our experience with high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) in 15 children with relapsed osteosarcoma who were treated by members of the Cooperative Osteosarcoma Study Group. Eight patients received HDC after the first relapse, six patients after the second relapse and one after the sixth relapse. Thirteen patients underwent HDC and ASCT in complete remission and two patients had macroscopic tumor residues. Seven patients received HDC based on melphalan and etoposide. Four of these patients were treated with additional carboplatinum. Two patients received carboplatinum, etoposide, and thiotepa or cyclophosphamide. In six patients double HDC was performed. In all six of these, the first HDC consisted of thiotepa/ cyclophosphamide. The second regimens included melphalan/etposide (two patients), melphalan/etposide/ carboplatinum (one patient), and melphalan/busulfan (one patient). Three of the 15 patients died of toxic complications. Eight patients developed further relapses, two patients showed persistent disease, and two patients are presently in continuous complete remission. The probability of relapse-free survival was 0.20 ± 0.12 within a median follow-up (MFU) of 8 months and the probability of overall survival was 0.29 ± 0.12 after a MFU of 16 months. In conclusion, utilization of HDC and ASCT in this patient group did not significantly improve the treatment outcome compared to conventional relapse therapy. Bone Marrow Transplantation (2001) 27, 933–937.
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References
Fuchs N, Bielack S, Epler D et al. Long-term results of the co-operative German–Austrian–Swiss osteosarcoma study group's protocol COSS-86 of intensive multidrug chemotherapy and surgery for osteosarcoma of the limbs Ann Oncol 1998 9: 893–899
Winkler K, Bielack SS, Delling G et al. Treatment of osteosarcoma: experience of the Cooperative Osteosarcoma Study Group (COSS) Cancer Treat Res 1993 62: 269–277
Atra A, Pinkerton R . Autologous stem cell transplantation in solid tumours of childhood Ann Med 1996 28: 159–164
Perentesis JP, Katsanis E, DeFor TE et al. Autologous stem cell transplantation for high-risk pediatric solid tumors Bone Marrow Transplant 1999 24: 609–615
Miniero R, Brach del Prever A, Vassallo E et al. Feasibility of high-dose chemotherapy and autologous peripheral blood stem cell transplantation in children with high grade osteosarcoma Bone Marrow Transplant 1998 22: (Suppl. 5) 37–40
Chan KW, Petropoulos D, Choroszy M et al. High-dose sequential chemotherapy and autologous stem cell reinfusion in advanced pediatric tumors Bone Marrow Transplant 1997 20: 1039–1043
Lazarus HM, Gray R, Ciobanu N et al. Phase I trial of high dose melphalan, high dose etoposide and autologous bone marrow re-infusion in solid tumors: an Eastern Cooperative Oncology Group (ECOG) study Bone Marrow Transplant 1994 14: 443–448
Boulad F, Kernan NA, LaQuaglia MP et al. High-dose induction chemoradiotherapy followed by autologous bone marrow transplantation as consolidation therapy in rhabdomyosarcoma, extraosseous Ewing's sarcoma, and undifferentiated sarcoma J Clin Oncol 1998 16: 1697–1706
Weaver CH, Bensinger WI, Appelbaum FR et al. Phase I study of high-dose busulfan, melphalan and thiotepa with autologous stem cell support in patients with refractory malignancies Bone Marrow Transplant 1994 14: 813–819
Diaz, Vicent MG, Madero L . High dose busulfan/melphalan as conditioning for autologous PBPC transplantation in pediatric patients with solid tumors Bone Marrow Transplant 1999 24: 1157–1159
Bielack S, Kempf-Bielack B, Schwenzer D et al. Neoadjuvant therapy for localized osteosarcoma of extremities. Results from the cooperative osteosarcoma study group COSS of 925 patients Klin Padiatr 1999 211: 260–270
Matthay KK, Villablanca JG, Seeger RC et al. Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. Children's Cancer Group New Engl J Med 1999 341: 1165–1173
Frohlich B, Ahrens S, Burdach S et al. High-dosage chemotherapy in primary metastasized and relapsed Ewing's sarcoma. (EI)CESS Klin Padiatr 1999 211: 284–290
Lucidarme N, Valteau-Couanet D, Oberlin O et al. Phase II study of high dose thiotepa and hematopoietic stem cell transplantation in children with solid tumors Bone Marrow Transplant 1998 22: 535–540
Colombat P, Biron P, Coze C et al. Failure of high-dose alkylating agents in osteosarcoma Bone Marrow Transplant 1994 14: 665–666
Saeter G, Hoie J, Stenwig AE et al. Systemic relapse of patients with osteogenic sarcoma. Prognostic factors for long term survival Cancer 1995 75: 1084–1093
Fagioli F, Brach del Prever A, Tienghi A et al. High dose chemotherapy (HD-CT) followed by peripheral blood stem cell (PBSC) rescue in relapsed osteosarcoma Bone Marrow Transplant 2000 25 (Suppl. 1): 72 (Abstr. 182)
Acknowledgements
We gratefully acknowledge the physicians, nurses, data-managers, and support staff of the collaborating centers for their active participation. The patients included in this report were treated at the following institutions: Children's University Hospital Frankfurt/M, Children's University Hospital Göttingen, Children's University Hospital Heidelberg, University of Jena, Department of Pediatrics, Children's University Hospital Lübeck, University of Münster, Department of Pediatric Hematology/ Oncology, Germany, St Anna Children's Hospital, Vienna, Austria.
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Sauerbrey, A., Bielack, S., Kempf-Bielack, B. et al. High-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplantation (ASCT) as salvage therapy for relapsed osteosarcoma. Bone Marrow Transplant 27, 933–937 (2001). https://doi.org/10.1038/sj.bmt.1703023
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DOI: https://doi.org/10.1038/sj.bmt.1703023
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