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Autologous hematopoietic cell transplantation in the treatment of solid tumors

Beata Młot, Krzysztof Gawroński, Sylwia Oborska, Wojciech Pielichowski, Piotr Rzepecki, Anna Waśko-Grabowska

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2011, 9 (3), p. 169-185
Streszczenie

High-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) has been used in the treatment of solid tumors since the ‘80s. Standard indications include breast cancer, ovarian cancer and germ cell tumors. Results of several phase II trials confirmed a beneficial effect of this therapeutic strategy on recurrence-free survival and total survival compared with conventional chemotherapy. Unfortunately, in most types of solid tumors, this effect has not been confirmed by phase III trials. Subsequently, the number of autologous transplantations in breast cancer decreased considerably. There is no evidence for any favorable effect of HDC in brain tumors and small cell lung cancer. According to 2006 EBMT recommendations, HDC followed by administration of hematopoietic cells is a therapeutic option in cases of therapy-resistant or recurrent primarily extragonadal germ cell tumors. A matter of debate is the use of this technique with similar indications in patients with germ cell tumors originating in the gonads. The first report on the effectiveness of HDC as first-line treatment of non-epithelial soft tissue tumors was by Pritchard et al. (1998). They documented improved event-free survival and total survival after administration of high doses of melphalan in children with stage IV neuroblastoma, achieving complete or very favorable partial remission after completed induction chemotherapy and surgical treatment. To date, neuroblastoma remains the only neoplasm, where randomized trials in children confirmed a favorable effect of transplantation of autologous hematopoietic cells on final treatment outcome.

Słowa kluczowe
autologous hematopoietic stem cell transplantation, solid tumors, germ cell tumors, neuroblastoma, high-dose chemotherapy