Clin Exp Pediatr > Epub ahead of print
DOI: https://doi.org/10.3345/cep.2022.00437    [Epub ahead of print]
Published online May 24, 2022.
Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand
Kunanya Suwannaying1  , Piti Techavichit2  , Patcharee Komvilaisak1  , Napat Laoaroon1  , Nattee Narkbunnam3  , Kleebsabai Sanpakit3  , Kanhatai Chiengthong2  , Thirachit Chotsampancharoen4  , Lalita Sathitsamitphong5  , Chalongpon Santong6  , Panya Seksarn2  , Suradej Hongeng7  , Surapon Wiangnon8 
1Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
2Integrative and Innovative Hematology/Oncology Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
3Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
4Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
5Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
6Cancer Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
7Division of Hematology-Oncology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
8Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
Correspondence: 
Piti Techavichit, Email: piti.t@chula.ac.th
Received: 13 March 2022   • Revised: 2 May 2022   • Accepted: 3 May 2022
Abstract
Background
In 2013, the Thai Pediatric Oncology Group (ThaiPOG) introduced a national protocol in which high-dose chemotherapy plus stem cell rescue is performed without immunotherapy.
Methods
This study aimed to elucidate the outcomes of high-risk neuroblastoma (HR-NB) patients treated with the ThaiPOG protocol. This retrospective cohort review included 48 patients (30 males, 18 females) with a median age of 3 years (range, 8 months to 18 years) who were treated at 5 ThaiPOG treatment centers in Thailand in 2000–2018.
Results
Eight of the 48 patients showed MYCN amplification. Twenty-three patients (48%) received 131I-meta-iodobenzylguanidine prior to high-dose chemotherapy and stem cell rescue. The majority of patients achieved a complete or very good response prior to consolidation treatment. The 5-year overall survival (OS) and event-free survival (EFS) rates were 45.1% and 40.4%, respectively. Patients aged >2 years had a nonsignificantly higher mortality risk (hazard ratio [HR], 2.66; 95% confidence interval [CI], 0.92–7.68; P=0.07). The MYCN amplification group had lower OS and EFS rates than the MYCN nonamplification group, but the difference was not statistically significant (45% OS and 37.5% EFS vs. 33.3% OS and 16.6% EFS; P=0.67 and P=0.67, respectively). Cis-retinoic acid treatment for 12 months was a strong prognostic factor that could reduce mortality rates among HR-NB patients (HR, 0.27; 95% CI, 0.09–0.785; P=0.01).
Conclusion
High-dose chemotherapy plus stem cell rescue followed by cis-retinoic acid for 12 months was well tolerated and could improve the survival rates of patients with HR-NB.
Key Words: High-risk neuroblastoma, High-dose chemotherapy plus stem cell rescue, Survival, Prognostic factors


METRICS Graph View
  • 0 Crossref
  •  0 Scopus
  • 777 View
  • 74 Download


Close layer
prev next