Autologous Bone Marrow Transplantation - Blog Science Connections

388 ABMT in Metastatic Neuroblastoma
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MONTHS POSTDIAGNOSIS
GROUP I patients
GROUP II patients
Figure 2. Disease-free survival according to response to primary therapy.
normal value was observed. Two episodes of veno-occlusive disease were
observed and rapidly resolved under symptomatic therapy.
On day 6 post-ABMT, one patient had generalized seizures with a sudden
elevation of glycemia from 4.6 mmol/1 to 120 mmol/1 during the same day. No
direct explanation for this hyperglycemia was found. In spite of progressive
improvement of this condition, he remained in a deep coma and died on day 11
post-ABMT. Post mortem histological examinations were not performed.
No cardiac, renal, or cerebral toxicity was found to be directly attributable to
this high-dose chemotherapy.
Infectious Complications
All patients experienced fever for a median duration of 10 days (range,
1-49 days). Following the first ABMT, 12 out of 33 patients (36%) had
bacteremia. Of the 18 patients who received a second ABMT, 4 (2256) had
bacteremia. One patient died of aspergillosis; the other patients recovered
under appropriate antibiotherapy.
Nine cases of interstitial pneumonitis were observed: three were related to
cytomegalovirus (CMV) infection and two were lethal; two were related to
Pneumocystis carinii and resolved under cotrimazole therapy; two occurred
during a septicemia (one bacterial and one candidial) and resolved under
antibiotherapy; one was of unknown origin and improved spontaneously; and
one was related to aspergillosis and was lethal.