Abstract
(Background) To improve the prognosis of high-risk neuroblastoma, we intensified the treatment by cord blood transplantation (CBT) with reduced-intensity conditioning (RIC).
(Patients and Methods) Fifteen consecutive patients with high-risk neuroblastoma, who were treated between 2005 and 2012 in our institution, were retrospectively reviewed.
(Results) Induction chemotherapy followed by high dose chemotherapy (HDC) was administered to all the patients. After HDC, primary tumor surgical resection was performed, and radiotherapy was administered to the primary site and residual metastases. The median patient age was 2.9 years. The chemotherapy responses were as follows: 2 patients showed a very good partial response, 11 showed a partial response, and 2 showed a mixed response. Five patients had no evidence of disease after treatment, but 8 patients experienced recurrences and 2 patients died from complications of HDC. The probabilities of event-free survival and overall survival at 5 years were 33.3±12.2% and 26.7±12.6%, respectively. Six patients were treated by CBT after local therapy. Either busulfan/fludarabine or melphalan/fludarabine was used for preconditioning for CBT. Grade I/II acute graft-versus-host disease was observed in 3 patients. No treatment-related death was observed. The relapse-free survival was not significantly different between groups (17.8 months with CBT vs 22.7 months without CBT, p=0.23).
(Conclusion) RIC-CBT for high-risk neuroblastoma was safely performed. However, patient prognosis did not improve.
