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A dose-intensive approach (NB96) for induction therapy utilizing sequential high-dose chemotherapy and stem cell rescue in high-risk neuroblastoma in children over 1 year of age

Background To improve outcome and overall survival (OS) in high‐risk neuroblastoma, NB96 induction therapy was intensified using sequential high‐dose chemotherapy and autologous stem cell rescue. Procedure Twenty children were included in this pilot study undertaken at seven reference centers in Fra...

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Published in:Pediatric blood & cancer 2011-12, Vol.57 (6), p.965-971
Main Authors: Monnereau-Laborde, Sylvie, Munzer, Caroline, Valteau-Couanet, Dominique, Ansoborlo, Sophie, Coze, Carole, Chastagner, Pascal, Rubie, Hervé, Demeocq, François, Stephan, Jean-Louis, Hartmann, Olivier, Perel, Yves
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container_title Pediatric blood & cancer
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creator Monnereau-Laborde, Sylvie
Munzer, Caroline
Valteau-Couanet, Dominique
Ansoborlo, Sophie
Coze, Carole
Chastagner, Pascal
Rubie, Hervé
Demeocq, François
Stephan, Jean-Louis
Hartmann, Olivier
Perel, Yves
description Background To improve outcome and overall survival (OS) in high‐risk neuroblastoma, NB96 induction therapy was intensified using sequential high‐dose chemotherapy and autologous stem cell rescue. Procedure Twenty children were included in this pilot study undertaken at seven reference centers in France, between May 1995 and October 1996. Induction began with one cycle of conventional chemotherapy followed by six sequential cycles of high‐dose chemotherapy comprising two cycles of etoposide 800 mg/m2/day over 3 days, two cycles of cyclophosphamide 2,000 mg/m2/day over 3 days, and two cycles of carboplatin 400 mg/m2/day over 5 days, followed by stem cell rescue. Results Thirteen patients (13/20) received this induction with acceptable toxicity and adequate stem cell harvest. Of these, nine (9/13) underwent surgery according to the protocol, while one patient was given a consolidation regimen prior to surgery. No toxic death was recorded. At the end of induction, complete remission was achieved in 10 cases (50%), with six still alive in July 2009. The 5‐year event‐free survival and OS were 35 ± 11% and 40 ± 11%, respectively. Conclusion NB96 therapy is feasible and tolerated without lethal toxicity. Nevertheless, given the small sample size and absence of randomization in our study, the effectiveness of this strategy based on metastasis complete response rates and long‐term outcome was not superior to other intensive chemotherapy regimens. Pediatr Blood Cancer 2011; 57: 965–971. © 2011 Wiley‐Liss, Inc.
doi_str_mv 10.1002/pbc.23232
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Procedure Twenty children were included in this pilot study undertaken at seven reference centers in France, between May 1995 and October 1996. Induction began with one cycle of conventional chemotherapy followed by six sequential cycles of high‐dose chemotherapy comprising two cycles of etoposide 800 mg/m2/day over 3 days, two cycles of cyclophosphamide 2,000 mg/m2/day over 3 days, and two cycles of carboplatin 400 mg/m2/day over 5 days, followed by stem cell rescue. Results Thirteen patients (13/20) received this induction with acceptable toxicity and adequate stem cell harvest. Of these, nine (9/13) underwent surgery according to the protocol, while one patient was given a consolidation regimen prior to surgery. No toxic death was recorded. At the end of induction, complete remission was achieved in 10 cases (50%), with six still alive in July 2009. The 5‐year event‐free survival and OS were 35 ± 11% and 40 ± 11%, respectively. Conclusion NB96 therapy is feasible and tolerated without lethal toxicity. Nevertheless, given the small sample size and absence of randomization in our study, the effectiveness of this strategy based on metastasis complete response rates and long‐term outcome was not superior to other intensive chemotherapy regimens. Pediatr Blood Cancer 2011; 57: 965–971. © 2011 Wiley‐Liss, Inc.</description><identifier>ISSN: 1545-5009</identifier><identifier>ISSN: 1545-5017</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.23232</identifier><identifier>PMID: 21744481</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Child ; Child, Preschool ; clinical trials ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; myeloablative therapy ; neuroblastoma ; Neuroblastoma - diagnosis ; Neuroblastoma - therapy ; Pilot Projects ; Stem Cell Transplantation - adverse effects ; Survival Analysis ; Transplantation, Autologous ; Treatment Outcome</subject><ispartof>Pediatric blood &amp; cancer, 2011-12, Vol.57 (6), p.965-971</ispartof><rights>Copyright © 2011 Wiley‐Liss, Inc.</rights><rights>Copyright © 2011 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3952-fe2a4aeeb8821d8342684f819b9d7cbe0798394e8fe18b73da4f6d88bf53d7713</citedby><cites>FETCH-LOGICAL-c3952-fe2a4aeeb8821d8342684f819b9d7cbe0798394e8fe18b73da4f6d88bf53d7713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21744481$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Monnereau-Laborde, Sylvie</creatorcontrib><creatorcontrib>Munzer, Caroline</creatorcontrib><creatorcontrib>Valteau-Couanet, Dominique</creatorcontrib><creatorcontrib>Ansoborlo, Sophie</creatorcontrib><creatorcontrib>Coze, Carole</creatorcontrib><creatorcontrib>Chastagner, Pascal</creatorcontrib><creatorcontrib>Rubie, Hervé</creatorcontrib><creatorcontrib>Demeocq, François</creatorcontrib><creatorcontrib>Stephan, Jean-Louis</creatorcontrib><creatorcontrib>Hartmann, Olivier</creatorcontrib><creatorcontrib>Perel, Yves</creatorcontrib><title>A dose-intensive approach (NB96) for induction therapy utilizing sequential high-dose chemotherapy and stem cell rescue in high-risk neuroblastoma in children over 1 year of age</title><title>Pediatric blood &amp; cancer</title><addtitle>Pediatr. Blood Cancer</addtitle><description>Background To improve outcome and overall survival (OS) in high‐risk neuroblastoma, NB96 induction therapy was intensified using sequential high‐dose chemotherapy and autologous stem cell rescue. Procedure Twenty children were included in this pilot study undertaken at seven reference centers in France, between May 1995 and October 1996. Induction began with one cycle of conventional chemotherapy followed by six sequential cycles of high‐dose chemotherapy comprising two cycles of etoposide 800 mg/m2/day over 3 days, two cycles of cyclophosphamide 2,000 mg/m2/day over 3 days, and two cycles of carboplatin 400 mg/m2/day over 5 days, followed by stem cell rescue. Results Thirteen patients (13/20) received this induction with acceptable toxicity and adequate stem cell harvest. Of these, nine (9/13) underwent surgery according to the protocol, while one patient was given a consolidation regimen prior to surgery. No toxic death was recorded. At the end of induction, complete remission was achieved in 10 cases (50%), with six still alive in July 2009. The 5‐year event‐free survival and OS were 35 ± 11% and 40 ± 11%, respectively. Conclusion NB96 therapy is feasible and tolerated without lethal toxicity. Nevertheless, given the small sample size and absence of randomization in our study, the effectiveness of this strategy based on metastasis complete response rates and long‐term outcome was not superior to other intensive chemotherapy regimens. Pediatr Blood Cancer 2011; 57: 965–971. © 2011 Wiley‐Liss, Inc.</description><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>clinical trials</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>myeloablative therapy</subject><subject>neuroblastoma</subject><subject>Neuroblastoma - diagnosis</subject><subject>Neuroblastoma - therapy</subject><subject>Pilot Projects</subject><subject>Stem Cell Transplantation - adverse effects</subject><subject>Survival Analysis</subject><subject>Transplantation, Autologous</subject><subject>Treatment Outcome</subject><issn>1545-5009</issn><issn>1545-5017</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNp1kcFu1DAQhiMEoqVw4AWQj-0hbRzbsXNsF1iQqsKhFG6WY082pokd7KSwvBVviJd094bm4JH8zSfN_Fn2GhfnuCjKi7HR5yVJ9SQ7xoyynBWYPz30RX2UvYjxe0Krgonn2VGJOaVU4OPszyUyPkJu3QQu2gdAahyDV7pDpzdXdXWGWh-QdWbWk_UOTR0ENW7RPNne_rZugyL8mMFNVvWos5su3-mQ7mDwe1Y5g-IEA9LQ9yhA1DMk5YIHG--Rgzn4pldx8oPafenO9iaAQ_4BAsJoCyog3yK1gZfZs1b1EV49vifZl_fvblcf8utP64-ry-tck5qVeQulogqgEaLERhBaVoK2AtdNbbhuoOC1IDUF0QIWDSdG0bYyQjQtI4ZzTE6y08WbzpE2jJMcbNxtoBz4OUpMKk5FyWqS0LMF1cHHGKCVY7CDCluJC7lLSKaE5L-EEvvmUTs3A5gDuY8kARcL8NP2sP2_SX6-Wu2V-TJh05V_HSZUuJcVJ5zJrzdrecdu19_eiju5In8BCyOsdA</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Monnereau-Laborde, Sylvie</creator><creator>Munzer, Caroline</creator><creator>Valteau-Couanet, Dominique</creator><creator>Ansoborlo, Sophie</creator><creator>Coze, Carole</creator><creator>Chastagner, Pascal</creator><creator>Rubie, Hervé</creator><creator>Demeocq, François</creator><creator>Stephan, Jean-Louis</creator><creator>Hartmann, Olivier</creator><creator>Perel, Yves</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope></search><sort><creationdate>20111201</creationdate><title>A dose-intensive approach (NB96) for induction therapy utilizing sequential high-dose chemotherapy and stem cell rescue in high-risk neuroblastoma in children over 1 year of age</title><author>Monnereau-Laborde, Sylvie ; Munzer, Caroline ; Valteau-Couanet, Dominique ; Ansoborlo, Sophie ; Coze, Carole ; Chastagner, Pascal ; Rubie, Hervé ; Demeocq, François ; Stephan, Jean-Louis ; Hartmann, Olivier ; Perel, Yves</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3952-fe2a4aeeb8821d8342684f819b9d7cbe0798394e8fe18b73da4f6d88bf53d7713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>clinical trials</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>myeloablative therapy</topic><topic>neuroblastoma</topic><topic>Neuroblastoma - diagnosis</topic><topic>Neuroblastoma - therapy</topic><topic>Pilot Projects</topic><topic>Stem Cell Transplantation - adverse effects</topic><topic>Survival Analysis</topic><topic>Transplantation, Autologous</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Monnereau-Laborde, Sylvie</creatorcontrib><creatorcontrib>Munzer, Caroline</creatorcontrib><creatorcontrib>Valteau-Couanet, Dominique</creatorcontrib><creatorcontrib>Ansoborlo, Sophie</creatorcontrib><creatorcontrib>Coze, Carole</creatorcontrib><creatorcontrib>Chastagner, Pascal</creatorcontrib><creatorcontrib>Rubie, Hervé</creatorcontrib><creatorcontrib>Demeocq, François</creatorcontrib><creatorcontrib>Stephan, Jean-Louis</creatorcontrib><creatorcontrib>Hartmann, Olivier</creatorcontrib><creatorcontrib>Perel, Yves</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><jtitle>Pediatric blood &amp; cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Monnereau-Laborde, Sylvie</au><au>Munzer, Caroline</au><au>Valteau-Couanet, Dominique</au><au>Ansoborlo, Sophie</au><au>Coze, Carole</au><au>Chastagner, Pascal</au><au>Rubie, Hervé</au><au>Demeocq, François</au><au>Stephan, Jean-Louis</au><au>Hartmann, Olivier</au><au>Perel, Yves</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A dose-intensive approach (NB96) for induction therapy utilizing sequential high-dose chemotherapy and stem cell rescue in high-risk neuroblastoma in children over 1 year of age</atitle><jtitle>Pediatric blood &amp; cancer</jtitle><addtitle>Pediatr. Blood Cancer</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>57</volume><issue>6</issue><spage>965</spage><epage>971</epage><pages>965-971</pages><issn>1545-5009</issn><issn>1545-5017</issn><eissn>1545-5017</eissn><abstract>Background To improve outcome and overall survival (OS) in high‐risk neuroblastoma, NB96 induction therapy was intensified using sequential high‐dose chemotherapy and autologous stem cell rescue. Procedure Twenty children were included in this pilot study undertaken at seven reference centers in France, between May 1995 and October 1996. Induction began with one cycle of conventional chemotherapy followed by six sequential cycles of high‐dose chemotherapy comprising two cycles of etoposide 800 mg/m2/day over 3 days, two cycles of cyclophosphamide 2,000 mg/m2/day over 3 days, and two cycles of carboplatin 400 mg/m2/day over 5 days, followed by stem cell rescue. Results Thirteen patients (13/20) received this induction with acceptable toxicity and adequate stem cell harvest. Of these, nine (9/13) underwent surgery according to the protocol, while one patient was given a consolidation regimen prior to surgery. No toxic death was recorded. At the end of induction, complete remission was achieved in 10 cases (50%), with six still alive in July 2009. The 5‐year event‐free survival and OS were 35 ± 11% and 40 ± 11%, respectively. Conclusion NB96 therapy is feasible and tolerated without lethal toxicity. Nevertheless, given the small sample size and absence of randomization in our study, the effectiveness of this strategy based on metastasis complete response rates and long‐term outcome was not superior to other intensive chemotherapy regimens. Pediatr Blood Cancer 2011; 57: 965–971. © 2011 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21744481</pmid><doi>10.1002/pbc.23232</doi><tpages>7</tpages></addata></record>
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source Wiley-Blackwell Read & Publish Collection
subjects Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Child
Child, Preschool
clinical trials
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Infant
Male
myeloablative therapy
neuroblastoma
Neuroblastoma - diagnosis
Neuroblastoma - therapy
Pilot Projects
Stem Cell Transplantation - adverse effects
Survival Analysis
Transplantation, Autologous
Treatment Outcome
title A dose-intensive approach (NB96) for induction therapy utilizing sequential high-dose chemotherapy and stem cell rescue in high-risk neuroblastoma in children over 1 year of age
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