Autologous Bone Marrow Transplantation - Blog Science Connections

Busulfan + Cyclophosphamide in Childhood Cancer
Table 2. Response After Bulsulfan and Cyclophosphamide
Response
Diagnosis CR PR OE F NE CR + PR (%)
Neuroblastoma 2 1 5 3 27
Non-Hodgkin's lymphoma 6 0 0 2 75
Rhabdomyosarcoma 1 1 1 2 40
Ewing's sarcoma 1 3 1 0 1 66
Total 10 5 7 7 1 52
Abbreviations: CR, complete remission; PR, partial remission; OE, objective effect;
F, failure; NE, nonevaluable.
Tumor Response
One patient died of treatment-related toxicity on day 13 post-BMT. He is
not actually évaluable for response, since, to be evaluated, the duration of
response should be at least 4 weeks. Among the 29 évaluable patients, 10
achieved a CR, 5 a PR, 7 an OE, and 7 F.
Of the 11 patients with neuroblastoma, 2 achieved a CR, 1 a PR, 5 an OE,
and 3 F. The CRs were achieved by two patients with residual bone marrow
involvement refractory to conventional chemotherapy. Two patients were
treated for unresectable stage 111 abdominal disease. The effects, as
measured by ultrasound tomography and CT scan, were only OE. However,
the possibilities of local excision were considerably improved after high-dose
chemotherapy and BMT: second laparotomies, performed in both patients
after BMT, led to a greater than 75% excision. Histologic examination of the
tumor tissue showed partially matured neuroblastoma.
Six of the eight patients with non-Hodgkin's lymphoma achieved CR. Six
of these lymphomas were of the Burkitt type and two of the lymphoblastic
type. It is noteworthy that in one of these patients central nervous system
involvement completely disappeared under this high-dose chemotherapy
regimen.
Of the six patients with metastatic Ewing's sarcoma, one died early of
toxicity. Histologic postmortem examination of the primary and the bone
metastases showed no detectable residual tumor. Among the five remaining
patients, one achieved a CR, three a PR, and one an OE.
Of the five patients with rhabdomyosarcoma, one achieved CR but
subsequently died of complications, 46 days post-BMT. Histologic postmortem
examination did not show any detectable residual disease. The four
remaining patients achieved one PR, one OE, and two Fs.
Duration of Response
In these patients with very advanced disease, duration of response was
usually short. It lasted 1 -23+ months, for a median of 6 months.