HealthDay News — Children with high-risk neuroblastoma have improved survival when they receive 2 autologous stem-cell transplants (ASCTs) rather than 1, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.
Julie Park, MD, professor of pediatrics at the University of Washington School of Medicine in Seattle, and colleagues treated 652 patients newly diagnosed with high-risk neuroblastoma, about 3 years old on average, between November 2007 and February 2012. Nearly 9 out of 10 children had stage 4 neuroblastoma. The children were randomly assigned to receive either 1 or 2 rounds of chemotherapy followed by a single or double (tandem) ASCT. In each group, about 3 out of 4 children also were randomly selected to receive immunotherapy on top of chemotherapy.
After 3 years, 61.4% of patients who underwent a tandem ASCT had not died or experienced a recurrence or worsening of their cancer. This compared to 48.4% of patients who underwent a single transplant, the researchers found. Children in both groups who also received immunotherapy did even better. Researchers achieved a 3-year event-free survival rate of 73.2% for tandem transplant patients, and 55.5% for single transplant recipients.
The addition of a second round of chemotherapy and stem cell transplant did not appear to increase the rate of severe toxicity, the researchers found. Fewer treatment-related deaths occurred among tandem transplant recipients, compared with single transplant patients. “This finding will change the way we treat children with high-risk neuroblastoma in North America, which still claims many young lives and is in urgent need of better treatments,” Dr Park said in a news release from the American Society of Clinical Oncology.
Park JR, Kreissman SG, London WB, et al. A phase III randomized clinical trial (RCT) of tandem myeloablative autologous stem cell transplant (ASCT) using peripheral blood stem cell (PBSC) as consolidation therapy for high-risk neuroblastoma (HR-NB): A Children’s Oncology Group (COG) study. Abstract LBA3. Presented at: ASCO 2016. June 3-7, 2016; Chicago.