Purpose:
@EN The poor histologic response to standard chemotherapy, a large tumor mass(more than 10 cm) at the time of the initial diagnosis, and tumors in axial bones are the risk factors for the relapse in sarcomas with preoperative and/or postoperative
standard chemotherapy and curative surgery. To overcome these problems, high-dose chemotherapy and stem cell rescue with autologous bone marrow transplantation were done in four osteogenic and Ewing's sarcomas.
@ES Methods: Bone-marrow harvest, cryopreservation and CFU-GM assay were done as described previously. As a high-dose chemotherapy, melphalan(160mg/m*) or ifosfamide(7,500mg/m*)+etoposide(600mg/m*)± carboplatin(600mg/m*)were used. Bone marrow
infusion
and supportive cares were followed until the hematologic recovery.
@EN Results:
@EN 1) The number of infused mononuclear cells and CFU-GM colonies were 0.8-2.9×108/kg and 0.1-1.2×106/kg, respectively.
2) The duration of absolute neutropenia(<500/mm*) and thrombocytopenia(<50.000/mm*) were 8~23 days and 0~25 days, respectively.
3) All but one had febrile neutropenia for 2~7 days due to sepsis and pneumonia, There was no therapy associated death.
4) All patients had complete response and the duration of disease free survival was 5+~51+months. Of the four patients in complete response, one subsequently relapsed in scalp 10 months after transplantation and died 6 months later due to
progression of
disease.
@ES Conclusion:
@EN It seems that high-dose chemotherapy with autologous bone marrow transplantation is feasible in high-risk osteosarcoma and Ewing's sarcoma and the responsiveness to chemotherapy may be the most important factor to predict the prognosis.
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