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Nephroblastoma

High-dose chemotherapy with autologous stem cell rescue in children with nephroblastoma

Bone Marrow Transplantation volume 30, pages 893–898 (2002)Cite this article

A Corrigendum to this article was published on 10 June 2003

Abstract

Children with Wilms tumor who have a particular risk of failure at relapse or at primary diagnosis were treated with high-dose chemotherapy (HDC) and autologous peripheral blood stem cell rescue in order to improve their probability of survival. From April 1992 to December 1998, 23 evaluable patients received HDC within the German Cooperative Wilms Tumor Studies. Nineteen were given melphalan, etoposide and carboplatin (MEC); the others received different regimens. The dose of carboplatin was adjusted according to renal function. Indications for HDC were high-risk relapse in 20 patients, bone metastases in two patients and no response in one patient. Fourteen of 23 patients are alive after a median observation time of 41 months, 11 of 14 in continuous complete remission, three in CR after relapse post HDC. The estimated survival and event-free survival for these patients are 60.9% and 48.2%. Twelve children relapsed after HDC; nine of them died within 12 months and three are surviving from 20 to 33 months after relapse. The main toxicities were hematologic, mucositis and renal (tubular dysfunction; intermittent hemodialysis in one patient). There were no toxic deaths. About half of the children suffering from Wilms tumor with very unfavorable prognostic factors survive disease-free after HDC for over 3 years. Besides hematological toxicity, mucositis and infections, renal function is at risk during HDC. With dose adjustment on glomerular filtration rate, however, no permanent renal failure was observed.

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Authors and Affiliations

  1. Department of Pediatric Hematology/Oncology, University of Essen, Germany

    B Kremens

  2. Department of Pediatric Hematology/Oncology, University of Jena, Germany

    B Gruhn & F Zintl

  3. Department of Pediatric Hematology/Oncology, University of Bonn, Germany

    C Hasan

  4. Department of Pediatric Hematology/Oncology, University of Düsseldorf, Germany

    H-J Laws

  5. Department of Pediatric Hematology/Oncology, University of Cologne, Germany

    B Hero

  6. Department of Pediatric Hematology/Oncology, University of Heidelberg, Germany

    B Selle

  7. Department of Pediatric Hematology/Oncology, University of Freiburg, Germany

    C Niemeyer

  8. Department of Pediatric Hematology/Oncology, University of Hamburg, Germany

    FG Finckenstein

  9. Department of Pediatric Hematology/Oncology, University of Ulm, Germany

    A Schulz

  10. Department of Pediatric Hematology/Oncology, University of Halle, Germany

    A Wawer

  11. Department of Pediatric Hematology/Oncology, University of Homburg/Saar, Germany

    N Graf

  12. Department of Pediatric Hematology, Oncology and Immunology, Olga-Hospital, Stuttgart, Germany

    E Koscielniak

  13. Department of Pediatric Hematology/Oncology, University of Frankfurt, Germany

    T Klingebiel

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  2. B Gruhn
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Kremens, B., Gruhn, B., Klingebiel, T. et al. High-dose chemotherapy with autologous stem cell rescue in children with nephroblastoma. Bone Marrow Transplant 30, 893–898 (2002). https://doi.org/10.1038/sj.bmt.1703771

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  • DOI: https://doi.org/10.1038/sj.bmt.1703771

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