A Case of Stage IV_A Neuroblastoma Transplanted with Autologous Marrow Treated by Using Magnetic Immunobeads Method

Abstract

We have successfully reconstituted a 3-year-old boy with stage IV_A neuroblastoma whose marrow was treated in vitro by monoclonal antibodies/magnetic immunobeads. The induction regimen included cyclophosphamide, vincristine, THP-adriamycin, and cisplatin. After four courses of the induction therapy, the primary tumor (ls-adrenal gland) was completely removed and the unresectable residual mass of lymph node was irradiated with 15 Gy. The tumor tissue had 30 copies of N-myc. Bone marrow cells were harvested, treated in vitro by using magnetic immunobeads method and cryopreserved. After the conditioning regimen with modified VAMP-TBI (teniposide, doxorubicin, L-phenylalanine mustard, cisplatin-total body irradiation) the purged marrow cells were transplanted on July 17th, 1986. He is disease free more than 1 year after transplantation. The intensive chemoradiotherapy and purged autologous marrow transplant, if carried out before development of progressive disease, will improve the outcome of patients with poor prognosis neuroblastoma.