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Conditioning Regimens

Toxicity of high-dose chemotherapy with etoposide, thiotepa and CY in treating poor-prognosis Ewing's sarcoma family tumors: the experience of the Bambino Gesù Children's Hospital

Bone Marrow Transplantation volume 45, pages 1274–1280 (2010)Cite this article

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Abstract

We report the toxicity of high-dose chemotherapy (HDC) based on etoposide, thiotepa and CY (ETC) in children with poor-prognosis Ewing's sarcoma family tumors (ESFTs). A total of 26 patients with high-risk ESFT (metastasis or axis localization or tumor volume >200 ml or necrosis <95%) were reviewed. The conditioning was based on etoposide (600 mg/m2), thiotepa (750 mg/m2) and CY (120 mg/kg) followed by autologous BM or PBSC rescue. The conditioning regimen was well tolerated, without any toxic deaths. The median time from transplant to a neutrophil count of >0.5 × 109/l was 10 days (range 6–27) and 22.5 days (range 9–114) for a plt count of >50 × 109/l. Oral mucositis was recorded in 20 patients, grade 1/2 in 19 and grade 3 in the last patient. Diarrhea grade 1/2 was recorded in four patients and grade 1/2 liver toxicity in four patients. Sepsis was documented in four cases and skin toxicity in three. Lung and tubular toxicity, respectively, were reported in one patient each. We conclude that the ETC regimen presented a limited and manageable toxicity. Further studies would confirm the role of ETC in high-risk ESFT.

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Acknowledgements

We thank L. Ravà, for statistical support and ‘Comitato Girasole Onlus per l’Oncologia del Bambin Gesù’ for grant support.

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Authors and Affiliations

  1. Pediatric Oncology Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy

    I Ilari, M A De Ioris, R Pessolano, C De Lurentis, L De Sio, P Fidani, A Jenkner & R Cozza

  2. Department of Pediatric Hematology-Oncology and BMT, Perugia, Italy

    G M Milano

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Ilari, I., De Ioris, M., Milano, G. et al. Toxicity of high-dose chemotherapy with etoposide, thiotepa and CY in treating poor-prognosis Ewing's sarcoma family tumors: the experience of the Bambino Gesù Children's Hospital. Bone Marrow Transplant 45, 1274–1280 (2010). https://doi.org/10.1038/bmt.2009.353

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