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Autografting

Successful treatment of metastatic retinoblastoma with high-dose chemotherapy and autologous stem cell rescue in South America

Bone Marrow Transplantation volume 47, pages 522–527 (2012)Cite this article

Abstract

High-dose chemotherapy (HDC) followed by autologous stem cell rescue (ASCR) is the only curative treatment for metastatic retinoblastoma, but its feasibility in developing countries is unknown. We report 11 consecutive children (six unilateral) treated in three South-American middle-income countries with HDC–ASCR. One patient had metastatic retinoblastoma at diagnosis and the remaining ones had a metastatic relapse. Metastatic sites included BM=6, bone=4, orbit=5 and central nervous system (CNS)=4. All patients received induction with conventional chemotherapy achieving CR at a median of 5.7 months from the diagnosis of metastasis. Conditioning regimens included carboplatin and etoposide with thiotepa in six or with CY in four or melphalan in one patient. All patients engrafted after G-CSF-mobilized peripheral blood ASCR and no toxic deaths occurred. Two children received post-ASCR CNS radiotherapy. Seven children have disease-free survival (median follow-up 39 months). CNS relapse, isolated (n=3) or with systemic relapse (n=1), occurring at a median of 7 months after ASCT was the most common event. In the same period, five children with metastatic retinoblastoma did not qualify for HDC–ASCR and died. We conclude that HDC–ASCR is a feasible and effective treatment for children with metastatic retinoblastoma in middle-income countries.

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Acknowledgements

This work was supported in part by the Fund for Ophthalmic Knowledge (GLC, CS), New York, NY, USA and Fundación Natali D Flexer de Ayuda al Niño con Cáncer (GLC, CS), Buenos Aires, Argentina and Cure2children, Florence, Italy.

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Author notes

  1. Pediatric Hematology and Oncology and Bone Marrow Transplantation Unit, Universidad Austral, Buenos Aires, Argentina

  2. Department of Hemato–Oncology, Hospital Pereyra Rosell, Montevideo, Uruguay

Authors and Affiliations

  1. Bone Marrow Transplantation Unit, Hospital Calvo Mackenna, Santiago, Chile

    J Palma & K Koop

  2. Bone Marrow Transplantation Unit, Instituto Argentino de Diagnostico y Tratamiento, Buenos Aires, Argentina

    D F Sasso

  3. Bone Marrow Transplantation Unit, Hospital Pereyra Rosell, Montevideo, Uruguay

    G Dufort & L Castillo

  4. Hemato–Oncology Service, Hospital Calvo Mackenna, Santiago, Chile

    C Sampor & G L Chantada

  5. Hemato–Oncology Service, Hospital JP Garrahan, Buenos Aires, Argentina

    B Diez

  6. Pediatric Oncology Department, FLENI, Buenos Aires, Argentina

    L Richard

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  1. J Palma
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Correspondence to G L Chantada.

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Palma, J., Sasso, D., Dufort, G. et al. Successful treatment of metastatic retinoblastoma with high-dose chemotherapy and autologous stem cell rescue in South America. Bone Marrow Transplant 47, 522–527 (2012). https://doi.org/10.1038/bmt.2011.108

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  • DOI: https://doi.org/10.1038/bmt.2011.108

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