Journal of Neuro-Oncology

, Volume 97, Issue 2, pp 247–255

A phase II prospective study of sequential myeloablative chemotherapy with hematopoietic stem cell rescue for the treatment of selected high risk and recurrent central nervous system tumors

  • Amy Rosenfeld
  • Morris Kletzel
  • Reggie Duerst
  • David Jacobsohn
  • Paul Haut
  • Joanna Weinstein
  • Alfred Rademaker
  • Colleen Schaefer
  • Lauren Evans
  • Molly Fouts
  • Stewart Goldman
Clinical Study - Patient Study

DOI: 10.1007/s11060-009-0009-z

Cite this article as:
Rosenfeld, A., Kletzel, M., Duerst, R. et al. J Neurooncol (2010) 97: 247. doi:10.1007/s11060-009-0009-z

Abstract

High risk/recurrent CNS tumors have a poor prognosis. We studied tandem high dose chemotherapy (HDC) with hematopoietic progenitor stem cell rescues (HPCR) as potentially curative therapy. Twenty-four patients (mean age 6.8 years) were enrolled, 19 underwent HDC/HPCR. Diagnoses were medulloblastoma (n = 9), germ cell tumor (n = 4), high grade astrocytoma (n = 2), supratentorial PNET (n = 1), pineoblastoma (n = 2), or papillary meningioma (n = 1). Cytoreduction regimen #1 consisted of carboplatin (500 mg/m2) × 3 days, etoposide (250 mg/m2) × 3 days, and thiotepa (300 mg/m2) × 3 days. Patients without progression or excessive toxicity (n = 11), received regimen #2 with melphalan (60 mg/m2) × 3 days and cyclophosphamide (1,500 mg/m2) × 4 days. Projected overall/event-free survival for the 19 patients was 51/37% and 34/28% at 1 and 5 years, respectively. Toxicity was significant with six treatment related deaths including four with veno-occlusive disease. This regimen of sequential HDC/HPCR in high risk/recurrent CNS tumor patients is not feasible due to toxicity.

Keywords

Pediatric high risk and brain tumorsPediatric recurrent brain tumorsMyeloablativeChemotherapyHematopoietic stem cell rescue

Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Amy Rosenfeld
    • 1
  • Morris Kletzel
    • 2
  • Reggie Duerst
    • 2
  • David Jacobsohn
    • 2
  • Paul Haut
    • 3
  • Joanna Weinstein
    • 2
  • Alfred Rademaker
    • 4
  • Colleen Schaefer
    • 2
  • Lauren Evans
    • 2
  • Molly Fouts
    • 2
  • Stewart Goldman
    • 2
  1. 1.Center for Cancer and Blood DisordersPhoenix Children’s HospitalPhoenixUSA
  2. 2.Division of Hematology, Oncology, TransplantationChildren’s Memorial Hospital Box #30ChicagoUSA
  3. 3.Section of Hematology/OncologyIndiana University School of MedicineIndianapolisUSA
  4. 4.Department of Preventative MedicineFeinberg School of Medicine Northwestern UniversityChicagoUSA