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Pediatric Transplants

High-dose chemotherapy (HDCT) with auto-SCT in children with atypical teratoid/rhabdoid tumors (AT/RT): a report from the European Rhabdoid Registry (EU-RHAB)

Abstract

A retrospective analysis of data from the European Rhabdoid Registry (EU-RHAB) was performed to describe the outcome of children with atypical teratoid/rhabdoid tumors (AT/RT) who underwent high-dose chemotherapy (HDCT) with auto-SCT. Nineteen patients (male, n=15; median age at diagnosis 21 months) were identified. Nine patients presented with metastatic disease at diagnosis. A partial or subtotal resection was achieved in 11, a total resection in five and a biopsy in three patients. Patients received a median of six chemotherapy cycles prior to HDCT. Additional radiotherapy was performed in 14 patients (first-line, n=9; following progression, n=5). Six patients underwent tandem auto-SCT. Disease status before HDCT was CR in six, PR in eight, stable disease in two and progressive disease (PD) in two patients (data missing, n=1). With a median follow-up of 16 months, 14 patients progressed. Estimated progression-free and OS at 2 years were 29% (±11%) and 50% (±12%), respectively. At last follow-up, eight patients were alive (first CR, n=4; second CR, n=2; PR, n=1; PD, n=1). Eleven patients died of PD. Median time-to-progression was 14 months. Selected patients with AT/RT might benefit from HDCT with radiotherapy. The definitive impact of this treatment modality has to be evaluated prospectively in a randomized trial.

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References

  1. Burger PC, Yu IT, Tihan T, Friedman HS, Strother DR, Kepner JL et al. Atypical teratoid/rhabdoid tumor of the central nervous system: a highly malignant tumor of infancy and childhood frequently mistaken for medulloblastoma: a Pediatric Oncology Group study. Am J Surg Pathol 1998; 22: 1083–1092.

    Article  CAS  Google Scholar 

  2. Woehrer A, Slavc I, Waldhoer T, Heinzl H, Zielonke N, Czech T et al. Incidence of atypical teratoid/rhabdoid tumors in children: a population-based study by the Austrian Brain Tumor Registry, 1996–2006. Cancer 2010; 116: 5725–5732.

    Article  Google Scholar 

  3. Rorke LB, Packer RJ, Biegel JA . Central nervous system atypical teratoid/rhabdoid tumors of infancy and childhood: definition of an entity. J Neurosurg 1996; 85: 56–65.

    Article  CAS  Google Scholar 

  4. von Hoff K, Hinkes B, Dannenmann-Stern E, von Bueren AO, Warmuth-Metz M, Soerensen N et al. Frequency, risk-factors and survival of children with atypical teratoid rhabdoid tumors (AT/RT) of the CNS diagnosed between 1988 and 2004, and registered to the German HIT database. Pediatr Blood Cancer 2011; 57: 978–985.

    Article  Google Scholar 

  5. Hilden JM, Meerbaum S, Burger P, Finlay J, Janss A, Scheithauer BW et al. Central nervous system atypical teratoid/rhabdoid tumor: results of therapy in children enrolled in a registry. J Clin Oncol 2004; 22: 2877–2884.

    Article  Google Scholar 

  6. Buscariollo DL, Park HS, Roberts KB, Yu JB . Survival outcomes in atypical teratoid rhabdoid tumor for patients undergoing radiotherapy in a Surveillance, Epidemiology, and End Results analysis. Cancer 2012; 118: 4212–4219.

    Article  Google Scholar 

  7. Dufour C, Beaugrand A, Le Deley MC, Bourdeaut F, André N, Leblond P et al. Clinicopathologic prognostic factors in childhood atypical teratoid and rhabdoid tumor of the central nervous system: a multicenter study. Cancer 2012; 118: 3812–3821.

    Article  Google Scholar 

  8. Lafay-Cousin L, Hawkins C, Carret AS, Johnston D, Zelcer S, Wilson B et al. Central nervous system atypical teratoid rhabdoid tumours: the Canadian Paediatric Brain Tumour Consortium experience. Eur J Cancer 2012; 48: 353–359.

    Article  CAS  Google Scholar 

  9. Tekautz TM, Fuller CE, Blaney S, Fouladi M, Broniscer A, Merchant TE et al. Atypical teratoid/rhabdoid tumors: improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy. J Clin Oncol 2005; 23: 1491–1499.

    Article  CAS  Google Scholar 

  10. Kordes U, Gesk S, Frühwald MC, Graf N, Leuschner I, Hasselblatt M et al. Clinical and molecular features in patients with atypical teratoid rhabdoid tumor or malignant rhabdoid tumor. Genes Chromosomes Cancer 2010; 49: 176–181.

    Article  CAS  Google Scholar 

  11. Modena P, Sardi I, Brenca M, Giunti L, Buccoliero AM, Pollo B et al. Case report: long-term survival of an infant syndromic patient affected by atypical teratoid-rhabdoid tumor. BMC Cancer 2013; 13: 100.

    Article  CAS  Google Scholar 

  12. Chi SN, Zimmerman MA, Yao X, Cohen KJ, Burger P, Biegel JA et al. Intensive multimodality treatment for children with newly diagnosed CNS atypical teratoid rhabdoid tumor. J Clin Oncol 2009; 20: 385–389.

    Article  Google Scholar 

  13. Zimmerman MA, Goumnerova LC, Proctor M, Scott RM, Marcus K, Pomeroy SL et al. Continuous remission of newly diagnosed and relapsed central nervous system atypical teratoid/rhabdoid tumor. J Neurooncol 2005; 72: 77–84.

    Article  Google Scholar 

  14. Gidwani P, Levy A, Goodrich J, Weidenheim K, Kolb EA . Successful outcome with tandem myeloablative chemotherapy and autologous peripheral blood stem cell transplants in a patient with atypical teratoid/rhabdoid tumor of the central nervous system. J Neurooncol 2008; 88: 211–215.

    Article  Google Scholar 

  15. Fidani P, De Ioris MA, Serra A, De Sio L, Ilari I, Cozza R et al. A multimodal strategy based on surgery, radiotherapy, ICE regimen and high dose chemotherapy in atypical teratoid/rhabdoid tumours: a single institution experience. J Neurooncol 2009; 92: 177–183.

    Article  Google Scholar 

  16. Nicolaides T, Tihan T, Horn B, Biegel J, Prados M, Banerjee A . High-dose chemotherapy and autologous stem cell rescue for atypical teratoid/rhabdoid tumor of the central nervous system. J Neurooncol 2010; 98: 117–123.

    Article  Google Scholar 

  17. Finkelstein-Shechter T, Gassas A, Mabbott D, Huang A, Bartels U, Tabori U et al. Atypical teratoid or rhabdoid tumors: improved outcome with high-dose chemotherapy. J Pediatr Hematol Oncol 2010; 32: e182–e186.

    Article  Google Scholar 

  18. Park ES, Sung KW, Baek HJ, Park KD, Park HJ, Won SC et al. Tandem high-dose chemotherapy and autologous stem cell transplantation in young children with atypical teratoid/rhabdoid tumor of the central nervous system. J Korean Med Sci 2012; 27: 135–140.

    Article  CAS  Google Scholar 

  19. Sung KW, Lim DH, Lee SH, Yoo KH, Koo HH, Kim JH et al. Tandem high-dose chemotherapy and auto-SCT for malignant brain tumors in children under 3 years of age. Bone Marrow Transplant 2013; 48: 932–938.

    Article  CAS  Google Scholar 

  20. Gardner SL, Asgharzadeh S, Green A, Horn B, McCowage G, Finlay J . Intensive induction chemotherapy followed by high dose chemotherapy with autologous hematopoietic progenitor cell rescue in young children newly diagnosed with central nervous system atypical teratoid rhabdoid tumors. Pediatr Blood Cancer 2008; 51: 235–240.

    Article  Google Scholar 

  21. Finlay J, Dhall G, Haley K, Erdreich-Epstein A, Gonzalez I, Allen J et al. Irradiation-avoiding strategy for treatment of young children with central nervous system atypical teratoid/rhabdoid tumors: the head start experience, 1991–2009. Pediatr Blood Cancer 2009; 53: 728 (abstract O.058).

    Google Scholar 

  22. Bourdeaut F, Lequin D, Brugières L, Reynaud S, Dufour C, Doz F et al. Frequent hSNF5/INI1 germline mutations in patients with rhabdoid tumor. Clin Cancer Res 2011; 17: 31–38.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Petra Neumayer (EU-RHAB trial center Augsburg, Germany) for excellent data management and administrative support. EU-RHAB is supported by the Deutsche Kinderkrebsstiftung (German Childhood Cancer Foundation).

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Correspondence to M Benesch or M C Frühwald.

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Supplementary Information accompanies the paper on Bone Marrow Transplantation website

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Benesch, M., Bartelheim, K., Fleischhack, G. et al. High-dose chemotherapy (HDCT) with auto-SCT in children with atypical teratoid/rhabdoid tumors (AT/RT): a report from the European Rhabdoid Registry (EU-RHAB). Bone Marrow Transplant 49, 370–375 (2014). https://doi.org/10.1038/bmt.2013.208

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