First experience of treatment of high-risk neuroblastoma patients using autologous peripheral blood stem cells transplantation
Igor N. Vyatkin1,2, Egor V. Shorikov1,2, Andrey A. Igumenshev1,2, Larisa V. Vakhonina1,2, Natalya G. Maisheva1,2, Yulia A. Yakovleva1,2, Grigory A. Tsaur1,2, Alexander M. Popov1,2,3, Elizaveta R. Semenikhina1, Leonid I. Savelyev1,2,3, Larisa G. Fechina1,2
1Regional Children Hospital 1, Ekaterinburg, Russia; 2Research Institute of Medical Cell Technologies, Ekaterinburg, Russia; 3Ural State Medical Academy, Ekaterinburg, Russia
Correspondence
Egor Shorikov, S. Deryabina Street 32, 620149 Ekaterinburg, Russia, Regional Children Hospital 1, Pediatric Oncology & Hematology Center, Phone: +7 (343) 216-6881, Fax: +7 (343) 216-6887
E-mail: cohc@bk.ru
Summary
Objective
To investigate the efficacy of auto-PBSCT in patients (pts) with high-risk (HR) neuroblastoma.
Methods
From June 2007 to August 2008 five pts with HR neuroblastoma were recruited. There were 3 boys and 2 girls aged from 11 to 113 months (median 52). Three pts with stage 4 and 2 pts with relapsed neuroblastoma (4 in CR and 1 in PR) received auto-PBSCT with a regimen of Melphalan 135 mg/m2+etoposide 40 mg/kg+carboplatin 1500 mg/m2. In all patients PBSCs were mobilized with G-CSF 10 µg/kg/day for 6 days and leukapheresis was performed on days 5 and 6 of G-CSF administration by cell separator. In 3 out of 5 cases positive immunomagnetic selection of CD34+ harvested cells was carried out. The median purity and viability of selected CD34+ cells was 97.1% (range 88.2%–97.4%) and 91.8% (range 71.6%–99.6%), respectively. The median number of administered CD34+ cells was 11.3×106/kg (range 5.1 to 41.4×106/kg).
Results
All children demonstrated engraftment. The median time for take of neutrophils and platelets after auto-PBSCT was 11 days (range 9–40) and 40 days (range 13–79), respectively. No patients experienced organ toxicities greater than WHO grade II or life-threatening infections. Progression disease was documented in 1 patient and 2 relapses were registered at the median time of 223 days (range 188–390); 2 patients remained in CR for 295 and 534 days. Both relapsed patients died; the other 3 are alive.
Conclusion
These preliminary results suggest that auto-PBSCT can be considered a curative therapeutic approach in patients with HR neuroblastoma.
Keywords
neuroblastoma, PBSCT, children, CD34+ cell selection
