Autologous Bone Marrow Transplantation - Blog Science Connections

Bone Marrow Transplantation in an CJnselected
Group of 65 Patients With Stage IV
Neuroblastoma
T. Philip, J. M. Zucker, J. L Bernard, P. Biron, B. Kremens,
E. Quintana, J. C. Gentet, P. Bordigoni, D. Frappaz,
G. Souillet, I. Philip, F. Chauvin, and M. Faorot
Neuroblastoma is the commonest malignancy disease of childhood before
the age of 5 years (1). Despite considerable progress in pediatric oncology,
neuroblastoma has remained a fatal disease for 90% of patients with stage IV
disease and for at least 70% of children who have the disease after age 1.
Several reports using high-dose melphalan followed by autologous bone
marrow transplantation (ABMT) have shown promising response rates in
phase II studies (2-4), even in some chemoresistant patients, and, in some
cases, long survival (5,6). The Philadelphia group (7,8) achieved a 36%
survival rate at 12 months in a group of patients in relapse selected as
responders to irradiation rescue protocols. These investigators were the first
to use fractionated total body irradiation (TBI) associated with a melphalancontaining,
high-dose chemotherapy regimen, and the preliminary results in
the relapsed patients were better than those reported for patients receiving
high-dose melphalan alone or in combination with other drugs (2,4,9).
Moreover, in vitro studies using cell lines have produced further support for
the use of TBI in this disease (10). Several groups have reported encouraging
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