The role of high-dose chemotherapy in treatment of children with malignant solid tumors
Summary. Thanks to the HD chemotherary with stem cells transplantation rates for malignant tumors in children at high risk has increased significantly. Application of autologous hematopoietic support GSK in children has become standard in many treatment programs, the number of autotransplantation in the world is constantly growing. From 2004 to 2011 in the Department of Pediatric Oncology of the National Cancer Institute conducted 39 courses of high dose chemotherapy with transplantation of peripheral blood stem cell (PBCS) in 39 patients with solid malignancies. Among them, 25 patients with high-risk neuroblastoma, 10 — with Ewing’s sarcoma, 3 — Wilms’ tumor, 1 — with metastatic teratoblastoma. This method was used to consolidate remission in patients who showed good response to induction chemotherapy. Results: 24 (61.5%) patients of 39 who received chemotherapy with transplantation currently alive: 20 (51.3%) of them are in complete remission and 4 (10,2%) — continue treatment relapse. 2 (5%) patients died early after transplantation on infectious complications. High-dose chemotherapy with transplantation of PBCS in the first line of therapy for high risk neuroblastoma and Ewing’s sarcoma allowed to reach the level of a five-year disease-free survival in neuroblastoma — 42%, and Ewing’s sarcoma — 32%, which meets or approaches the performance of advanced clinics around the world.
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