According to an article recently published in the Journal of Clinical Oncology, treatment including induction chemotherapy, surgery, radiation therapy, and two (tandem) autologous stem cell transplants can provide long-term survival in approximately half of patients with high-risk neuroblastoma.
Neuroblastoma is a disease in which cancerous cells form in the nerve tissues of the adrenal gland, neck, chest, or spinal cord. Although neuroblastoma is rare (it affects roughly 650 children and adolescents in the U.S. each year), it is the most common malignancy diagnosed in infants.
The severity of neuroblastoma is classified as “high”, “intermediate”, or “low”; classifications refer to the risk of a cancer recurrence or cancer progression following standard therapies. Patients classified as “low” have a significantly improved outcome compared to those classified as “high”.
An autologous stem cell transplant is a procedure in which higher than normal doses of therapy are used in an attempt to kill more cancer cells. Unfortunately, the high doses of therapy also kill more immature blood cells, referred to hematopoietic stem cells. The decrease in stem cell levels can leave a patient susceptible to life-threatening infection, anemia, and bleeding.
To control the side effects of an autologous stem cell transplant, a patient’s stem cells are collected prior to the high-dose therapy and re-infused following treatment. In tandem autologous stem cell transplants, two courses of high-dose therapy are given and each course is followed by a stem cell infusion.
Researchers from the Dana-Farber Cancer Institute recently conducted a clinical trial evaluating initial chemotherapy, surgery, radiation therapy, and tandem autologous stem cell transplants in high-risk neuroblastoma. This trial included 91 patients Eighty-two patients completed treatment. At a follow-up of approximately four years, these results were observed:
- 50% of patients were alive and cancer-free.
- 42% of patients experienced a cancer relapse.
- At five years, the overall survival is estimated to be 60%.
- 5% of patients died from treatment-related complications.
- Among the 82 patients who completed treatment, progression-free survival was 54%
The researchers concluded that initial chemotherapy, surgery, radiation therapy, and tandem autologous stem cell transplants provide encouraging long-term survival among patients with high-risk neuroblastoma. Parents of patients with high-risk neuroblastoma may wish to speak with their physician regarding their children’s individual risks and benefits of participating in a clinical trial further evaluating this treatment regimen or other promising therapeutic regimens. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: George RE, Li S, Medeiros-Nancarrow C, et al. High-risk neuroblastoma treated with tandem autologous peripheral-blood stem cell-supported transplantation: Long-term survival update. Journal of Clinical Oncology. 2006;24:2891-2896.
Related News: Chemotherapy and Autologous Stem Cell Transplant Improve Outcome for Children with Neuroblastoma (8/23/2005)
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