Authors: Soo Hyun Lee Meong Hi Son Ki Woong Sung Young Bae Choi Na Hee Lee Keon Hee Yoo Hong Hoe Koo Do Hoon Lim Hyung Jin Shin
Publish Date: 2014/08/10
Volume: 120, Issue: 3, Pages: 507-513
Abstract
The number of studies examining the use of tandem highdose chemotherapy and autologous stem cell transplantation HDCT/autoSCT to treat highrisk or recurrent brain tumors is increasing However studies addressing the toxicity associated with tandem HDCT/autoSCT particularly during the second HDCT/autoSCT are very limited For this reason we retrospectively evaluated the toxicity of tandem HDCT/autoSCT with carboplatinthiotepaetoposide CTE and cyclophosphamidemelphalan CM regimens when used to treat highrisk or recurrent brain tumors A total of 109 patients who received a first HDCT/autoSCT and 100 who proceeded to a second HDCT/autoSCT between May 2005 and December 2013 were included Hematologic recovery was rapid during both the first and second HDCT/autoSCT In the first HDCT/autoSCT mucositisrelated gastrointestinal toxicity was frequent and two 18 patients died from toxicity one hepatic venoocclusive disease VOD and one sepsis In the second HDCT/autoSCT mucositisrelated toxicity was milder than in the first round However hepatic VOD frequency was high 200 and six 60 patients died from toxicity four hepatic VODs one asphyxia and one sepsis Multivariate analysis indicated that age younger than 8 years was the only significant predictor for hepatic VOD All six patients who died from toxicity during the second HDCT/autoSCT were younger than 9 years of age This study demonstrates that tandem HDCT/autoSCT using CTE/CM regimens was generally feasible However dose reduction during the second HDCT/autoSCT in young children might be needed to decrease the death rate from toxicity
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