Онкопедиатрия. 2018; 5: 188-195
Успешное лечение пациента с плевропульмональной бластомой и множественными костными метастазами: клинический случай
https://doi.org/10.15690/onco.v5i3.1936Аннотация
Обоснование. Плевропульмональная бластома (ППБ) является редкой первичной эмбриональной опухолью легкого у детей. В настоящее время описаны три гистологических варианта ППБ с возможной трансформацией типа I в типы II и III. Прогноз у пациентов с ППБ при наличии отдаленных метастазов рассматривается как неблагоприятный.
Описание клинического случая. В настоящей статье представлено описание случая развития ППБ I типа у ребенка 14 мес жизни с последующей трансформацией в ППБ II типа в рецидиве заболевания, наличием множественных костных метастазов. Целью настоящей публикации явилась демонстрация успешного лечения и достижения долгосрочной бессобытийной выживаемости у пациента со множественными костными метастазами ППБ на фоне интенсивной полихимиотерапии и высокодозной терапии с аутологичной трансплантацией гемопоэтических стволовых клеток.
Заключение. Случай иллюстрирует возможность достижения длительной бессобытийной выживаемости у пациентов с рецидивами ППБ и наличием множественных костных метастазов.
Список литературы
1. Dishop MK, Kuruvilla S. Primary and metastatic lung tumors in the pediatric population: a review and 25-year experience at a large children’s hospital. Arch Pathol Lab Med. 2008;132(7):1079– 1103.
2. Messinger YH, Stewart DR, Priest JR, et al. Pleuropulmonary blastoma: a report on 350 central pathology-confirmed pleuropulmonary blastoma cases by the international Pleuropulmonary Blastoma Registry. Cancer. 2015;121(2):276–285. doi: 10.1002/cncr.29032.
3. Priest JR, McDermott MB, Bhatia S, et al. Pleuropulmonary blastoma: a clinicopathologic study of 50 cases. Cancer. 1997;80(1):147–161. doi: 10.1002/(sici)1097-0142(19970701)80:1<147::aidcncr20>3.0.co;2-x.
4. Manivel JC, Priest JR, Watterson J, et al. Pleuropulmonary blastoma. The so-called pulmonary blastoma of childhood. Cancer. 1988;62(8):1516–1526. doi: 10.1002/1097-0142(19881015)62:8<1516::aidcncr2820620812>3.0.co;2-3.
5. Bisogno G, Brennan B, Orbach D, et al. Treatment and prognostic factors in pleuropulmonary blastoma: an EXPeRT report. Eur J Cancer. 2014;50(1):178–184. doi: 10.1016/j.ejca.2013.08.015.
6. Tulla M, Berthold F, Graf N, et al. Incidence, trends, and survival of children with embryonal tumors. Pediatrics. 2015;136(3):e623–632. doi: 10.1542/ peds.2015-0224.
7. Priest JR, Magnuson J, Williams GM, et al. Cerebral metastasis and other central nervous system complications of pleuropulmonary blastoma. Pediatr Blood Cancer. 2007;49(3):266–273. doi: 10.1002/ pbc.20937.
8. Indolfi P, Bisogno G, Casale F, et al. Prognostic factors in pleuro-pulmonary blastoma. Pediatr Blood Cancer. 2007;48(3):318–323. doi: 10.1002/ pbc.20842.
9. Sparber-Sauer M, Seitz G, Kirsch S, et al. The impact of local control in the treatment of type II/III pleuropulmonary blastoma. Experience of the Cooperative Weichteilsarkom Studiengruppe (CWS). J Surg Oncol. 2017;115(2):164–172. doi: 10.1002/jso.24416.
10. ppbregistry.org [Internet]. The International Pleuropulmonary Blastoma Registry [cited 2018 Feb 01]. Available from: http://www.ppbregistry.org.
11. Kushner BH, Kramer K, Modak S, Cheung NK. Irinotecan plus temozolomide for relapsed or refractory neuroblastoma. J Clin Oncol. 2006;24(33):5271– 5276. doi: 10.1200/JCO.2006.06.7272.
12. Kaneko H, Isogai K, Kondo M, et al. Autologous peripheral blood stem cell transplantation in a patient with relapsed pleuropulmonary blastoma. J Pediatr Hematol Oncol. 2006;28(6):383–385. doi: 10.1097/00043426-200606000-00012.
13. de Castro CG Jr, de Almeida SG, Gregianin LJ, et al. High-dose chemotherapy and autologous peripheral blood stem cell rescue in a patient with pleuropulmonary blastoma. J Pediatr Hematol Oncol. 2003;25(1):78–81. doi: 10.1097/00043426200301000-00016.
14. Qayed M, Powell C, Morgan ER, et al. Irinotecan as maintenance therapy in high-risk hepatoblastoma. Pediatr Blood Cancer. 2010;54(5):761–763. doi: 10.1002/pbc.22408.
15. Raciborska A, Bilska K, Drabko K, et al. Vincristine, irinotecan, and temozolomide in patients with relapsed and refractory Ewing sarcoma. Pediatr Blood Cancer. 2013;60(10):1621–1625. doi: 10.1002/pbc.24621.
16. Wagner LM, Perentesis JP, Reid JM, et al. Phase I trial of two schedules of vincristine, oral irinotecan, and temozolomide (VOIT) for children with relapsed or refractory solid tumors: a Children’s Oncology Group phase I consortium study. Pediatr Blood Cancer. 2010;54(4):538–545. doi: 10.1002/pbc.22407.
17. Ohta Y, Fujishima M, Hasegawa H, et al. High therapeutic effectiveness of postoperative irinotecan chemotherapy in a typical case of radiographically and pathologically diagnosed pleuropulmonary blastoma. J Pediatr Hematol Oncol. 2009;31(5):355–358. doi: 10.1097/MPH.0b013e318196a422.
Oncopediatrics. 2018; 5: 188-195
Successful Treatment of Pleuropulmonary Blastoma with Multiple Bone Metastases: Case Study
https://doi.org/10.15690/onco.v5i3.1936Abstract
Background. Pleuropulmonary blastoma (PPB) is a rare primary embryonal tumor of the lung in children. Three main histological variants of PPB with a possible transformation of type I into type II and III are now described. The prognosis in pleuropulmonary blastoma patients with distant metastases is considered to be unfavorable.
Case Report. The article presents the case of type I PPB development in a 14-month-old child followed by the transformation of type I PPB into type II in the setting of relapse with multiple bone metastases. The aim of the article was to provide reliable data on successful treatment and achievement of long-term event-free survival in a PPB patient with multiple bone metastases who underwent intensive chemotherapy and high-dose therapy with autologous hematopoietic stem cell transplantation.
Conclusion. The case study demonstrates the possibility for achievement of long-term event-free survival in PPB patients with multiple bone metastases and relapses.
References
1. Dishop MK, Kuruvilla S. Primary and metastatic lung tumors in the pediatric population: a review and 25-year experience at a large children’s hospital. Arch Pathol Lab Med. 2008;132(7):1079– 1103.
2. Messinger YH, Stewart DR, Priest JR, et al. Pleuropulmonary blastoma: a report on 350 central pathology-confirmed pleuropulmonary blastoma cases by the international Pleuropulmonary Blastoma Registry. Cancer. 2015;121(2):276–285. doi: 10.1002/cncr.29032.
3. Priest JR, McDermott MB, Bhatia S, et al. Pleuropulmonary blastoma: a clinicopathologic study of 50 cases. Cancer. 1997;80(1):147–161. doi: 10.1002/(sici)1097-0142(19970701)80:1<147::aidcncr20>3.0.co;2-x.
4. Manivel JC, Priest JR, Watterson J, et al. Pleuropulmonary blastoma. The so-called pulmonary blastoma of childhood. Cancer. 1988;62(8):1516–1526. doi: 10.1002/1097-0142(19881015)62:8<1516::aidcncr2820620812>3.0.co;2-3.
5. Bisogno G, Brennan B, Orbach D, et al. Treatment and prognostic factors in pleuropulmonary blastoma: an EXPeRT report. Eur J Cancer. 2014;50(1):178–184. doi: 10.1016/j.ejca.2013.08.015.
6. Tulla M, Berthold F, Graf N, et al. Incidence, trends, and survival of children with embryonal tumors. Pediatrics. 2015;136(3):e623–632. doi: 10.1542/ peds.2015-0224.
7. Priest JR, Magnuson J, Williams GM, et al. Cerebral metastasis and other central nervous system complications of pleuropulmonary blastoma. Pediatr Blood Cancer. 2007;49(3):266–273. doi: 10.1002/ pbc.20937.
8. Indolfi P, Bisogno G, Casale F, et al. Prognostic factors in pleuro-pulmonary blastoma. Pediatr Blood Cancer. 2007;48(3):318–323. doi: 10.1002/ pbc.20842.
9. Sparber-Sauer M, Seitz G, Kirsch S, et al. The impact of local control in the treatment of type II/III pleuropulmonary blastoma. Experience of the Cooperative Weichteilsarkom Studiengruppe (CWS). J Surg Oncol. 2017;115(2):164–172. doi: 10.1002/jso.24416.
10. ppbregistry.org [Internet]. The International Pleuropulmonary Blastoma Registry [cited 2018 Feb 01]. Available from: http://www.ppbregistry.org.
11. Kushner BH, Kramer K, Modak S, Cheung NK. Irinotecan plus temozolomide for relapsed or refractory neuroblastoma. J Clin Oncol. 2006;24(33):5271– 5276. doi: 10.1200/JCO.2006.06.7272.
12. Kaneko H, Isogai K, Kondo M, et al. Autologous peripheral blood stem cell transplantation in a patient with relapsed pleuropulmonary blastoma. J Pediatr Hematol Oncol. 2006;28(6):383–385. doi: 10.1097/00043426-200606000-00012.
13. de Castro CG Jr, de Almeida SG, Gregianin LJ, et al. High-dose chemotherapy and autologous peripheral blood stem cell rescue in a patient with pleuropulmonary blastoma. J Pediatr Hematol Oncol. 2003;25(1):78–81. doi: 10.1097/00043426200301000-00016.
14. Qayed M, Powell C, Morgan ER, et al. Irinotecan as maintenance therapy in high-risk hepatoblastoma. Pediatr Blood Cancer. 2010;54(5):761–763. doi: 10.1002/pbc.22408.
15. Raciborska A, Bilska K, Drabko K, et al. Vincristine, irinotecan, and temozolomide in patients with relapsed and refractory Ewing sarcoma. Pediatr Blood Cancer. 2013;60(10):1621–1625. doi: 10.1002/pbc.24621.
16. Wagner LM, Perentesis JP, Reid JM, et al. Phase I trial of two schedules of vincristine, oral irinotecan, and temozolomide (VOIT) for children with relapsed or refractory solid tumors: a Children’s Oncology Group phase I consortium study. Pediatr Blood Cancer. 2010;54(4):538–545. doi: 10.1002/pbc.22407.
17. Ohta Y, Fujishima M, Hasegawa H, et al. High therapeutic effectiveness of postoperative irinotecan chemotherapy in a typical case of radiographically and pathologically diagnosed pleuropulmonary blastoma. J Pediatr Hematol Oncol. 2009;31(5):355–358. doi: 10.1097/MPH.0b013e318196a422.
