2018 Volume 55 Issue 3 Pages 269-273
The current treatment for patients with high-risk neuroblastoma is high-intensity chemotherapy, which results in myelosuppression and severe infections. According to the European Group, busulphan-melphalan high-dose chemotherapy following a rapid induction regimen known as COJEC is superior and less toxic than other treatments. In this study, we retrospectively assessed the disease status and side effects of the COJEC regimen (cisplatin, vincristine, carboplatin, etoposide, and cyclophosphamide) and compared them with those of regimen A (cyclophosphamide, vincristine, pirarubicin, and cisplatin). From February 2007 to December 2015, 18 patients with newly diagnosed high-risk neuroblastoma were treated at our institution. Ten patients underwent regimen A, and 8 patients underwent the rapid COJEC. After induction treatments, the CR or VGPR response was achieved in 7 of 10 patients in regimen A and in 7 of 8 patients in the rapid COJEC. The patients in the rapid COJEC had significantly fewer days with severe leucopenia (P<0.002) and neutropenia (P<0.005) per 100 days. There was no significant difference in the number of days with G-CSF and febrile neutropenia episodes between the two groups. The rapid COJEC induction regimen appears safe against severe leucopenia and neutropenia in pediatric patients in whom high-risk neuroblastoma was newly diagnosed. However, follow-up of long-term effects including hearing loss and renal toxicity is needed.
