High-dose chemotherapy and autologous peripheral blood stem cell transplantation in adult patients with high-risk or advanced Ewing and soft tissue sarcoma

  • M. Engelhardt
  • R. Zeiser
  • G. Ihorst
  • J. Finke
  • C. I. Müller
Original Paper
First Online:
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Accepted:

Abstract

Purpose

Despite the availability of combined-modality treatment for Ewing sarcoma (ES) and soft tissue sarcomas (STS), results from independent groups still indicate a poor prognosis for high-risk and metastasized patients. The benefit of high-dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplantation (ASCT) as compared to standard treatment is not defined.

Methods

Here, we report of HDCT in 35 consecutive adult patients with poor-risk ES or rhabdomyosarcoma (n = 11) and STS (n = 24) undergoing ASCT between July 1992 and March 2003. At a median follow-up of 100.6 months after ASCT, 11 patients are alive, with nine in sustained complete remission (CR) and each one in partial remission (PR) and stable disease. Median overall survival (OS) from ASCT was 17.1 months. Response to pretreatment, Karnofsky index > 80%, R 0 resection and first-line ASCT were associated with long-term OS (p < 0.05).

Conclusion

These data indicate that (1) patients achieving a CR or PR following induction, with preserved performance status and R 0 resection may benefit from ASCT and (2) that this can be an useful therapeutic modality in a subset of patients, in some achieving remarkable responses.

Keywords

Soft tissue sarcoma Ewing sarcoma High-dose chemotherapy Autologous stem cell transplantation 
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Notes

Acknowledgements

We thank the internal reviewer in our institution and Dr. Jürgen Heinz for critical reading of the manuscript and valuable comments. We thank Mrs. I. Matt and our entire transplantation staff for their excellent support and patient care.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • M. Engelhardt
    • 1
  • R. Zeiser
    • 1
    • 3
  • G. Ihorst
    • 2
  • J. Finke
    • 1
  • C. I. Müller
    • 1
    • 4
  1. 1.Department of Hematology and OncologyFreiburg University Medical CenterFreiburgGermany
  2. 2.Institute of Medical Biometry and Medical InformaticsUniversity of FreiburgFreiburgGermany
  3. 3.Division of Bone Marrow Transplantation, Department of MedicineStanford University School of MedicineStanfordUSA
  4. 4.Division of Hematology/Oncology, Cedars-Sinai Medical CenterDavid Geffen School of Medicine at UCLALos AngelesUSA

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