Tandem thiotepa with autologous hematopoietic cell rescue in patients with recurrent, refractory, or poor prognosis solid tumor malignancies Journal Article
| Authors: | Osorio, D. S.; Dunkel, I. J.; Cervone, K. A.; Goyal, R. K.; Steve Lo, K. M.; Finlay, J. L.; Gardner, S. L. |
| Article Title: | Tandem thiotepa with autologous hematopoietic cell rescue in patients with recurrent, refractory, or poor prognosis solid tumor malignancies |
| Abstract: | Background: The purpose of this study was to determine the feasibility and tolerability of tandem courses of high-dose thiotepa with autologous hematopoietic cell rescue (AHCR) in patients with recurrent, refractory solid tumors who were ineligible for a single course of high-dose therapy due to greater than minimal residual disease. Patients with decreased hearing or poor renal function were eligible. Procedure: Thiotepa was administered intravenously at a dose of 200 mg/m2/day (6.67 mg/kg/day) daily for 3 days followed by AHCR. A second course of thiotepa was given 4 weeks later provided blood counts recovered sufficiently without evidence of tumor progression. Results: Fifty-eight patients received 96 courses. Thirty-eight (65%) patients received two courses of therapy. Twenty-seven courses (28%) were administered completely in the outpatient setting. A toxic mortality rate of 3.4% was observed. Five of 26 patients with medulloblastoma were alive at a median of 35 months, whereas 21 patients died at a median of 11.7 months. Four of five patients with central nervous system germ cell tumors (CNS GCT) were alive 68–103 months following AHCR. Conclusions: Two cycles of high-dose thiotepa with AHCR were well tolerated even in these heavily pretreated patients. This therapy may provide prolonged survival in patients with recurrent malignant brain tumors, particularly medulloblastoma and CNS GCT. © 2017 Wiley Periodicals, Inc. |
| Keywords: | adolescent; adult; cancer chemotherapy; child; preschool child; school child; treatment response; middle aged; cancer surgery; young adult; major clinical study; cancer radiotherapy; prospective study; neoplasm; infection; practice guideline; retinoblastoma; thiotepa; cancer survivor; cerebrospinal fluid; infant; kidney function; glioblastoma; medulloblastoma; hematopoietic cell; total parenteral nutrition; liver disease; ependymoma; malignancy; hematopoietic stem cell; morphine; tumor growth; leiomyosarcoma; rhabdomyosarcoma; germ cell tumor; gastrointestinal disease; autologous hematopoietic stem cell transplantation; anaplastic carcinoma; thrombocyte transfusion; nephroblastoma; respiratory tract disease; cerebrospinal fluid cytology; central nervous system disease; transplant; craniospinal irradiation; pineoblastoma; tandem; autologous hematopoietic cell rescue; cancer prognosis; amphotericin; human; male; female; priority journal; article; solid malignant neoplasm; recurrent refractory solid tumor |
| Journal Title: | Pediatric Blood and Cancer |
| Volume: | 65 |
| Issue: | 1 |
| ISSN: | 1545-5009 |
| Publisher: | Wiley Periodicals, Inc |
| Date Published: | 2018-01-01 |
| Start Page: | e26776 |
| Language: | English |
| DOI: | 10.1002/pbc.26776 |
| PROVIDER: | scopus |
| PUBMED: | 28905508 |
| PMCID: | PMC6816488 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 January 2018 -- Source: Scopus |
