Resumen

PEREZ MARTINEZ, A. et al. Altas dosis de quimioterapia y soporte hematopoyético en el tratamiento de niños con meduloblastoma y tumor neuroectodérmico primitivo supratentorial de alto riesgo. Oncología (Barc.) [online]. 2004, vol.27, n.2, pp.24-32. ISSN 0378-4835.

PURPOSE: The combination of high-dose chemotherapy (HDC) and autologous stem cells rescue (ASCR) has been reported as a new relevant treatment improving survival rates of patients with cerebellar medulloblastoma and supratentorial neuroectodermal tumors. We report our preliminary results employing the procedure. MATERIAL AND METHODS: We study 19 patients treated with HDC and ASCR; 13 of them were high risk patients, and 6 had recurrent disease. The patients received granulocyte colony-stimulating factor (G-CSF) at a dose of 12 µg/kg/12 h during four days to stimulate granulocytes proliferation and mobilization. The patients were conditioned with busulfan-melphalan. Additionally, thiotepa was administered to three patients, and topotecan to four. The peripheral blood progenitor cells were collected and infused 48 h after finishing chemotherapy. RESULTS: In an average follow-up of 18 months (range 5-63 months) after transplantation, 9 patients (47%) survived disease-free, 8 with complete remission and 1 with partial remission. Three patients (15%) died due to the toxic effects of the treatment, and 7 (36%) because of disease progression. According to the Kaplan-Meier method, the disease-free survivors were 37.67 ± 14% as a whole, and 57 ± 15% for the high risk patients. CONCLUSIONS: Although the combined use of high-dose chemotherapy and autologous hemopoietic stem cells transplantation is a toxic treatment, in our experience it improves the survival of patients with high risk medulloblastoma and supratentorial primitive neuroectodermal tumors, especially of the later.

Palabras clave : Peripheral blood progenitor cells; Autologous transplantation; High-dose chemotherapy; High-risk brain tumors; Medulloblastoma; Supratentorial primitive neuroectodermal tumors.

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