Cancer Research and Treatment

Original Articles

Clinical Characteristics and Treatment Results of Pediatric Osteosarcoma: The Role of High Dose Chemotherapy with Autologous Stem Cell Transplantation: Ji Won Lee, Hyery Kim, Hyoung Jin Kang, Han-Soo Kim, Sung-Hye Park, In-One Kim, Hyo Seop Ahn, Hee Young Shin; Cancer Res Treat. 2008;40(4):172-177. Published online December 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.4.172

Purpose

In this study, we investigated the clinical characteristics and treatment results of osteosarcoma during the past 7 years, and evaluated the role of high dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT).

Materials and Methods

We retrospectively analyzed the clinical data of patients who were diagnosed as osteosarcoma at our center from January, 2000 to December, 2007.

Results

The 5-year overall survival and event-free survival of the patients were 72.6% and 55.9%, respectively. Seventeen (41.5%) patients showed disease progression during treatment or relapse after the end of treatment. The patients who had metastasis at diagnosis or who had a lower grade of necrosis after neoadjuvant chemotherapy showed decreased overall and event-free survival. Four patients received ASCT after HDCT, and 3 of them are alive without disease.

Conclusions

The patients who relapsed or had refractory osteosarcoma or who had metastasis at diagnosis or a lower grade of necrosis after neoadjuvant chemotherapy showed poor prognosis. HDCT with ASCT could be an alternative treatment option for these patients.

Citations

Citations to this article as recorded by

High‐dose chemotherapy followed by autologous stem cell transplantation in pediatric patients with relapsed osteosarcoma
Sung Han Kang, Wanlim Kim, Jong Seok Lee, Jin Kyung Suh, Hyery Kim, Dong Kwan Kim, Se Hoon Choi, Hee Won Cho, Hee Young Ju, Keon Hee Yoo, Ki Woong Sung, Hong Hoe Koo, Sung Wook Seo, Ho Joon Im, Ji Won Lee, Kyung‐Nam Koh
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Favorable outcome of high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with nonmetastatic osteosarcoma and low-degree necrosis
Kyung Taek Hong, Hyun Jin Park, Bo Kyung Kim, Hong Yul An, Jung Yoon Choi, Jung-Eun Cheon, Sung-Hye Park, Han-Soo Kim, Hyoung Jin Kang
Frontiers in Oncology.2022;[Epub] CrossRef
The Outcome of Children With Malignant Bone Tumors: A Single-Center Experience
Mohammadreza Bordbar, Ali Sarfaraz, Sezaneh Haghpanah, Omidreza Zekavat, Soheila Zareifar, Tahereh Zarei
Global Pediatric Health.2021;[Epub] CrossRef
1
L.V. Hryvkova
Practical oncology.2021; 4(1): 30. CrossRef
Retrospective analysis of high-dose chemotherapy followed by autologous stem cell transplantation for high-risk pediatric osteosarcoma
Suguru Uemura, Takeshi Mori, Shinya Ishiko, Satoru Takafuji, Nanako Nino, Nobuyuki Yamamoto, Akira Hayakawa, Noriyuki Nishimura, Hitomi Hara, Teruya Kawamoto, Toshihiro Akisue, Kazumoto Iijima
Pediatric Hematology and Oncology.2020; 37(4): 337. CrossRef
Pulmonary tuberculosis mimicking radiation pneumonitis in a patient with neck malignancy
Kyungsoo Bae, Kyung Nyeo Jeon, Hoon Sik Choi, Dae Hyun Song, Ho Cheol Kim
Medicine.2019; 98(27): e16398. CrossRef
High-dose chemotherapy and autologous stem cell transplantation with melphalan, etoposide and carboplatin for high-risk osteosarcoma
C R Hong, H J Kang, M S Kim, H Y Ju, J W Lee, H Kim, H-S Kim, S-H Park, K D Park, J D Park, H Y Shin, H S Ahn
Bone Marrow Transplantation.2015; 50(10): 1375. CrossRef
High‐dose chemotherapy with stem cell rescue in the primary treatment of metastatic and pelvic osteosarcoma: Final results of the ISG/SSG II study
Kjetil Boye, Adalberto Brach Del Prever, Mikael Eriksson, Gunnar Sæter, Amelia Tienghi, Paula Lindholm, Franca Fagioli, Sigmund Skjeldal, Stefano Ferrari, Kirsten Sundby Hall
Pediatric Blood & Cancer.2014; 61(5): 840. CrossRef
LY294002 suppresses the malignant phenotype and sensitizes osteosarcoma cells to pirarubicin chemotherapy
XIN HUA LONG, ZHEN HAO ZHONG, AI FEN PENG, LIANG BO ZHU, HENG WANG, GUO MEI ZHANG, ZHI LI LIU
Molecular Medicine Reports.2014; 10(6): 2967. CrossRef
Prognostic significance of early lymphocyte recovery in pediatric osteosarcoma
Colin Moore, Don Eslin, Alejandro Levy, Jessica Roberson, Vincent Giusti, Robert Sutphin
Pediatric Blood & Cancer.2010; 55(6): 1096. CrossRef
Cryoimmunologic Antitumor Effects Enhanced by Dendritic Cells in Osteosarcoma
Masanori Kawano, Hideji Nishida, Yasunari Nakamoto, Hiroshi Tsumura, Hiroyuki Tsuchiya
Clinical Orthopaedics and Related Research®.2010; 468(5): 1373. CrossRef

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High Dose Chemotherapy and Autologous Peripheral Blood Stem Cell Transplantation for Persistent/Relapsed Ovarian Cancer: So Eun Kim, Jong Ho Won, Hyun Soo Kim, Joon Sung Park, Chan Kyu Kim, Kyu Taeg Lee, Sung Kyu Park, Seung Ho Baick, Dae Sik Hong, Hee Sook Park, Hugh Chul Kim; Cancer Res Treat. 2002;34(6):439-443. Published online December 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.6.439

Abstract PDF

PURPOSE
High dose chemotherapy (HDC) is increasingly being used for ovarian cancer. Although early studies of autotransplantation for advanced ovarian cancer have been encouraging, most reported series were small, and no randomized trials have been reported. HDC and autologous hematopoietic stem cell transplantation were rarely performed in patients with ovarian cancer in Korea, and no results have been reported with the exception of one case report.
MATERIALS AND METHODS
We retrospectively analyzed 10 patients with refractory or relapsed ovarian cancer having received HDC and autologous peripheral blood stem cell transplantation (APBSCT), between January 1996 and September 1998, at the Soon Chun Hyang and Ajou University Hospitals.
RESULTS
Ten patients were treated with HDC and APBSCT. Six patients achieved complete response (CR) and 1 a partial response (PR), with a response rate of 70%. Three patients did not respond following mobilization chemotherapy, and failed to respond after HDC. The median duration of progression free survival (PFS) and overall survival (OS) were 6 (4~46) and 13 (3~50+) months, respectively. The median duration of OS of the responders following mobilization chemotherapy was 23 (8~50+) compared with 12 (3~18) months of the non- responders. With regard to the treatment related toxicity, 8 patients had neutropenic fevers, and bacteremia was documented in 4. The non-hematological toxicities were never life threatening, and there were no treatment related deaths.
CONCLUSION
HDC, followed by APBSCT, is well-tolerated patients with refractory or relapsed ovarian cancer, and following mobilization chemotherapy the responders survived longer than the non-responders.

Citations

Citations to this article as recorded by

Analysis of chromosomal changes in serous ovarian carcinoma using high‐resolution array comparative genomic hybridization: Potential predictive markers of chemoresistant disease
Sang Wun Kim, Jae Wook Kim, Young Tae Kim, Jae Hoon Kim, Sunghoon Kim, Bo Sung Yoon, Eun Ji Nam, Hye Yeon Kim
Genes, Chromosomes and Cancer.2007; 46(1): 1. CrossRef

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High Dose Chemotherapy with Ifosfamide, Carboplatin, and Etoposide Followed by Autologous Stem Cell Transplantation in Breast Cancer: Soo Mee Bang, Se Hoon Lee, Eun Kyung Cho, Jung Ae Lee, Young Suk Park, Dong Bok Shin, Jae Hoon Lee, Yung Jue Bang, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim; J Korean Cancer Assoc. 2000;32(6):1059-1066.

Abstract PDF: PURPOSE
To establish the feasibility of high dose ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by autologous stem cell transplantation (ASCT) in patients with high-risk or metastatic breast cancer.
MATERIALS AND METHODS
High-risk breast cancer is defined as 10 or more involved axillary lymph nodes (n=3) or stage III (n=2). Patients with metastatic cancer have relapsed diseases after curative resection (n=10) or initially metastatic lesion (n=1). Colony stimulating factor with either cyclophosphamide or combination chemotherapy was administered to mobilize the stem cells. High dose chemotherapy consisted of ifosfamide 16 g/m2, carboplatin 1.8 g/m2, and etoposide 0.75 g/m2 (dose I) and later modified to ifosfamide 12 g/m2, carboplatin 1.35 g/m2, and etoposide 1.2 g/m2 (dose II).
RESULTS
The median duration of grunulocyte nadir (<500/ microliter) was 11 (10~17) days and platelet transfusion dependency (<20,000/ microliter) was 11 (7~53) days in 14 patients who achieved engraftment. One out of 5 patients with high-risk breast cancer relapsed after high dose therapy. Two patients remain disease-free at 18th and 40th months. Two among the 4 patients treated with dose I died due to treatment-related complications. The responses of metastatic diseases to ICE chemotherapy were 1 continuing CR, 1 CR, 1 PR, 4 SD and 3 PD in 10 evaluable patients.
CONCLUSION
High dose ICE chemotherapy, especially dose II and ASCT were feasible in high-risk or metastatic breast cancer.

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Clinical Trial

High Dose Cyclophosphamide, Thiotepa, and Carboplatin followed by Autologous Peripheral Stem Cell Rescue in Patients with Responsive Metastatic or High - Risk Primary Breast Cancer: Se Haeng Cho, Sang Hee Kim, Young Joo Min, Sung Joon Choi, Jung Kyun Kim, Tae Won Kim, Jong Soo Choi, Dai Young Zang, Je Hwan Lee, Sung Bae Kim, Cheol Won Suh, Kyoo Hyung Lee, Jung Shin Lee, Woo Kun Kim, Se Hyun Ahn, Jung Mi Park, Sang We Kim; J Korean Cancer Assoc. 1998;30(1):100-105.

Abstract PDF: PURPOSE
Positive correlation between dosage of antineoplastic agents and tumor response is well demonstrated in advanced breast cancer. But severe bone marrow depression limit the clinical application of high dose chemotherapy. Autologous peripheral blood stem cell transplantation(PBSCT) after high dose chemotherapy(HDC) was introduced to promote rapid bone marrow recovery. This study was designed to establish the feasibility of combining high dose cyclophosphamide, thiotepa, and carboplatin chemotherapy followed by stem cell rescue in patients with responsive metastatic or high risk primary breast cancer.
MATERIALS AND METHOD
Eligibility criteria included the presence of high risk primary breast cancer(10 or more involved axillary lymph node, n=4), recurrent disease after curative resection(n=6) or stage IV disease at the time of diagnosis(n=1). The responses of recurrent disease to initial chemotherapy were 4 complete responses and 1 partial responses. One recurrent case with solitary pulmonary metastasis underwent metastasectomy and got chemotherapy after operation. Colony stimulating factor was administered to mobilize stem cells from bone marrow to peripheral blood. The stem cell collection was performed 4~10 times(median 4) and the number of collected stem cell was 1.95~7.34x10(8)kg(median 4.87x10(8)/kg). High dose chemotherapy with CTCb (cyclophosphamide 1,500 mg/m2/day, thiotepa 125 mg/m2/day, carboplatin 200 mg/m2/ day) was performed from day -7 to day -4 and peripheral stem cell infusion was performed on day 0 as planned.
RESULT
Eleven patients were enrolled in this study. Their median age was 39 years old. The median time for bone marrow recovery was 11 days for neutrophil(>500/mm2) and 28 days for platelet(>50,000/mm2). Packed red blood cell and platelet transfusion were performed in 11 patients. The group whose infused mononuclear cell count was less than 4.0 x 10(8)/kg(n=9) needed longer time for bone marrow recovery than those(n=2) who had more than 4.0 x 10(8)/kg( 20 vs 13 day, p < 0.05 ). For non-hematologic toxicity, none have experienced toxicity more than grade III. There were 2 recurrences of 4 cases with high risk breast cancer at the 22 th, and 25 th month but they are still alive at the 28 th, and 29 th month each. The other 2 cases are alive without recurrences at the 18 th, and 20 th months each. In the recurrent disease group, one case who showed partial response to initial chemotherapy recurred at the 4 th month and died at the 13 th month after PBSCT. The other 5 cases are alive without recurrence at the 1st, 3 rd, 3 rd, 5 th, and 31 th month each. One case with stage IV disease(bone metastasis) is alive without evidence of progression at the 3 rd month.
CONCLUSION
High dose chemotherapy with PBSCT can be performed safely. Long term survival of patients with advanced breast cancer would be possible by PBSCT after HDC. Further clinical trials based on larger patient population is required to evaluate clinical efficacy of PBSCT after HDC in high risk and recurrent breast cancer.

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