| 골 육종 및 유잉 육종에서 자가골수이식을 이용한 고용량 항암화학요법 |
| 한지연, 문한림, 김동욱, 이종욱, 진종률, 한치화, 민우성, 박종원, 김춘추, 김동집, 김학기, 우영균, 김정만 |
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| High - dose Chemotherapy Followed by Autologous Bone Marrow Transplantation in High - risk Osteosarcoma and Ewing's Sarcoma |
| Ji Youn Han, Han Lim Moon, Dong Wook Kim, Jong Wook Lee, Jong Youl Jin, Chi Wha Han, Woo Sung Min, Chong Won Park, Choon Choo Kim, Dong Jip Kim, Hak Ki Kim, Young Gyun Woo, Jung Man Kim |
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| ABSTRACT |
Purpose:
The poor histologic response to standard chemotherapy, a large tumor mass(more than 10 cm) at the time of the initial diagnosis, and tumors in axial bones are the risk factors for the relapse in sarcomas with preoperative and/or postoperative standard chemotherapy and curative surgery. Ta overcome these problems, high-dose chemotherapy and stem cell rescue with autologous bone marrow transplantation were done in four osteogenic and Ewings sarcomas.
Method:
Bone-marrow harvest, cryopreservation and CFU-GM assay were done as described previously. As a high-dose chemotherapy, melphalan(160 mg/m) or ifosfamide(7,500 mg2/m)+etoposide(600mg/m) + carboplatin(600 mg/m(2)) were used. Bone marrow infusion and supportive cares were followed until the hematalogic recovery.
Results:
1) The number of infused mononuclear cells and CFU-GM colonies were 0.8-2.9 x 10(8)/kg and 0.1-1.2 x 10(4)/kg, respectively. 2) The duration of absolute neutropenia(<500/mm(3)) and thrombocytopenia(<50,000/mm(3)) were 8-23 days and 0-25 days, respectively. 3) All but one had febrile neutropenia for 2 7 days due to sepsis and pneumonia. There waa no therapy associated death. 4) All patients had complete response and the duration of disease free survival was 5(+)-51(+) months. Of the four patients in complete response, one subsequently relapsed in scalp l0 months after transplantation and died 6 months later due to progression of disease. Conclasion: It seems that high-dose chemotherapy with atologous bone marrow transplantation is feasible in high-risk osteosarcoma and Ewing's sarcoma and the responsiveness to chemotherapy may be the most important factor to predict the prognosis. |
| Key words:
Sarcoma, Auto1ogous bone marrow transplantation |
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