Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2024; 23: 40-46
Высокодозная химиотерапия с аутологичной трансплантацией гемопоэтических стволовых клеток в лечении рецидивов медуллобластомы у детей
https://doi.org/10.24287/1726-1708-2024-23-2-40-46Аннотация
Рецидивы медуллобластомы (МБ) обладают гетерогенным клиническим течением и продолжают оставаться сложной терапевтической задачей. В зарубежной литературе представлены данные о низкой эффективности и значимой токсичности высокодозной химиотерапии с аутологичной трансплантацией гемопоэтических стволовых клеток (ВДХТ с ауто-ТГСК) в лечении пациентов с рецидивом МБ.
Нами проведен анализ эффективности и переносимости ВДХТ с ауто-ТГСК у 9 пациентов детского и подросткового возраста с рецидивом МБ, референс морфологии и нейровизуализации которых был выполнен в ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» в период с июля 2013 по декабрь 2021 года.
Целью работы явилась оценка эффективности противорецидивной терапии с включением ВДХТ с ауто-ТГСК в лечении рецидивов МБ в педиатрической практике.
Список литературы
1. Sabel M., Fleischhack G., Tippelt S., Gustafsson G., Doz F., Kortmann R., et al. SIOP-E Brain Tumour Group. Relapse patterns and outcome after relapse in standard risk medulloblastoma: a report from the HITSIOP-PNET4 study. J Neurooncol 2016; 129 (3): 515–24.
2. Fleischhack G. HIT-REZ 2005 Multicenter, cooperative therapy optimization study and phase II study for the treatment of children, adolescents and young adults with therapy-resistant or recurrent primitive neuroectodermal brain tumors (medulloblastomas, supratentorial PNETs) and ependymomas.
3. Massimino M., Gandola L., Spreafico F., Biassoni V., Luksch R., Collini P., et al. No salvage using highdose chemotherapy plus/minus reirradiation for relapsing previously irradiated medulloblastoma. Int J Radiat Oncol Biol Phys 2009; 73: 1358–63.
4. Dunkel I.J., Gardner S.L., Garvin J.H., Jr., Goldman S., Shi W., Finlay J.L. High-dose carboplatin, thiotepa, and etoposide with autologous stem cell rescue for patients with previously irradiated recurrent medulloblastoma. Neuro Oncol 2010; 12: 297– 303.
5. Gaab C., Adolph J.E., Tippelt S., Mikasch R., Obrecht D., Mynarek M., et al. Local and Systemic Therapy of Recurrent Medulloblastomas in Children and Adolescents: Results of the P-HIT-REZ 2005 Study. Cancers 2022; 14: 471.
6. Peyrl A., Chocholous M., Kieran M.W., Azizi A.A., Prucker C., Czech T., et al. Antiangiogenic metronomic therapy for children with recurrent embryonal brain tumors. Pediatr Blood Cancer 2012; 59 (3): 511–7.
7. Slavc I., Mayr L., Stepien N., Gojo J., Aliotti Lippolis M., Azizi A.A., et al. Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach. Cancers (Basel) 2022; 14 (20): 5128. DOI: 10.3390/cancers14205128
Pediatric Hematology/Oncology and Immunopathology. 2024; 23: 40-46
High-dose chemotherapy with autologous hematopoietic stem cell transplantation in the treatment of recurrent medulloblastoma in children
https://doi.org/10.24287/1726-1708-2024-23-2-40-46Abstract
Medulloblastoma (MB) recurrence can manifest in various clinical ways and still remains a major therapeutic challenge. As reported in the international literature, high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT) has low effectiveness and severe toxicity in patients with recurrent MB. Here, we analyzed the effectiveness and tolerability of HDCT with auto-HSCT in 9 pediatric and adolescent patients with MB relapses whose histological samples and magnetic resonance images had been reviewed at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology from July 2013 till December 2021. The aim of the study was to evaluate the effectiveness of the HDCT with auto-HSCT approach for the treatment of MB relapses in pediatric patients. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of Russia.
References
1. Sabel M., Fleischhack G., Tippelt S., Gustafsson G., Doz F., Kortmann R., et al. SIOP-E Brain Tumour Group. Relapse patterns and outcome after relapse in standard risk medulloblastoma: a report from the HITSIOP-PNET4 study. J Neurooncol 2016; 129 (3): 515–24.
2. Fleischhack G. HIT-REZ 2005 Multicenter, cooperative therapy optimization study and phase II study for the treatment of children, adolescents and young adults with therapy-resistant or recurrent primitive neuroectodermal brain tumors (medulloblastomas, supratentorial PNETs) and ependymomas.
3. Massimino M., Gandola L., Spreafico F., Biassoni V., Luksch R., Collini P., et al. No salvage using highdose chemotherapy plus/minus reirradiation for relapsing previously irradiated medulloblastoma. Int J Radiat Oncol Biol Phys 2009; 73: 1358–63.
4. Dunkel I.J., Gardner S.L., Garvin J.H., Jr., Goldman S., Shi W., Finlay J.L. High-dose carboplatin, thiotepa, and etoposide with autologous stem cell rescue for patients with previously irradiated recurrent medulloblastoma. Neuro Oncol 2010; 12: 297– 303.
5. Gaab C., Adolph J.E., Tippelt S., Mikasch R., Obrecht D., Mynarek M., et al. Local and Systemic Therapy of Recurrent Medulloblastomas in Children and Adolescents: Results of the P-HIT-REZ 2005 Study. Cancers 2022; 14: 471.
6. Peyrl A., Chocholous M., Kieran M.W., Azizi A.A., Prucker C., Czech T., et al. Antiangiogenic metronomic therapy for children with recurrent embryonal brain tumors. Pediatr Blood Cancer 2012; 59 (3): 511–7.
7. Slavc I., Mayr L., Stepien N., Gojo J., Aliotti Lippolis M., Azizi A.A., et al. Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach. Cancers (Basel) 2022; 14 (20): 5128. DOI: 10.3390/cancers14205128
