Abstract
Intensive chemotherapy, TBI, and BMT may improve the outcome for children with metastatic neuroblastoma (August, et al, 1982). We are testing a new four drug chemotherapy and TBI pretransplant regimen for its toxicity and efficacy. Five patients received cis-platinum, VM26, doxorubicin, melphalan, and TBI (VAMP-TBI); and 3 received melphalan and TBI (M-TBI) because they could not tolerate the other agents or because their tumor was judged resistent. Allogeneic (allo) marrow was given to 5 and autologous (auto) marrow to 3 patients. They were 1 1/2 to 7 yrs old when transplanted (median 5 yrs) and were transplanted 5-13 mos after diagnosis (median 10 mos). Auto marrow had no neuroblastoma cells by immunoperoxidase staining for neuron specific enolase and cell surface antigens, which detects 1 tumor cell/105 normal cells. The most consistent acute toxicity from VAMP-TBI was severe mucositis, vomiting, and diarrhea; M-TBI also caused these complications but to a lesser extent. One acute toxic death occurred with each regimen. Of the 5 patients receiving VAMP-TBI, 3 have no evidence of disease (NED) at 60 (auto), 195 (allo), and 317 (allo) days; and 1 (auto) is 7 days post transplantation. One of 3 receiving M-TBI is NED at 45 days (auto), and another has progressive disease at 189 days (allo). We conclude that VAMP-TBI is a tolerable conditioning regimen. The survival of 3 of 4 evaluable patients receiving VAMP-TBI with NED suggests that this regimen should continue to be investigated.
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Seeger, R., Lenarsky, C., Moss, T. et al. FOUR DRUG CHEMOTHERAPY, TOTAL BODY IRRADIATION (TBI) AND ALLOGENEIC OR AUTOLOGOUS BONE MARROW TRANSPLANTATION (EMT) FOR METASTATIC NEUROBLASTOMA. Pediatr Res 18 (Suppl 4), 248 (1984). https://doi.org/10.1203/00006450-198404001-00930
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DOI: https://doi.org/10.1203/00006450-198404001-00930