Abstract
We report here a case of recurrent metastatic medulloblastoma following treatment with peripheral blood-stem cell transplantation (PBSCT). A 16-year-old boy who had undergone surgery, radiation therapy and chemotherapy for cerebellar medulloblastoma at the age of 8 yr achieved complete remission. However, six years after the first treatment, he developed multiple bone metastases. Moreover two years after the first relapse, a bone marrow relapse occurred, followed by brain metastases two years later. The patient was treated with vincristine, cyclophosphamide, pirarubicin, etoposide (VP-16), etc., but he failed to achieve complete remission. High-dose chemotherapy with carboplatin+ melphalan+ VP-16 and PBSCT (1.25×108 mononuclear cells/kg and 0.99×105 CFU-GM/kg) were performed. From day 1 to day 15, he received granulocyte colony-stimulating factor. The absolute neutrophil count reached 500/μl on day 10, platelet count reached 50, 000/μl on day 16 and the reticulocyte count reached 1% on day 14. A bone scan and brain MRI survey for metastatic lesions on day 25 gave no evidence of residual tumors. But seven months after the PBSCT, he complained of bone pain. An additional bone scan and brain MRI revealed new metastatic sites. He was then treated using radiation and chemotherapies. The use of PBSCT for recurrent metastatic medulloblastoma may be of value but transiently. Further discussion about the timing and selection of anti-cancer drugs for PBSCT is required.
