Toxicity of high-dose chemotherapy with etoposide, thiotepa and CY in treating poor-prognosis Ewing's sarcoma family tumors: The experience of the Bambino Ges Children's Hospital

I. Ilari, M. A. De Ioris, G. M. Milano, R. Pessolano, C. De Lurentis, L. De Sio, P. Fidani, A. Jenkner, R. Cozza

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Abstract

We report the toxicity of high-dose chemotherapy (HDC) based on etoposide, thiotepa and CY (ETC) in children with poor-prognosis Ewing's sarcoma family tumors (ESFTs). A total of 26 patients with high-risk ESFT (metastasis or axis localization or tumor volume 200 ml or necrosis 95%) were reviewed. The conditioning was based on etoposide (600 mg/m 2), thiotepa (750 mg/m 2) and CY (120 mg/kg) followed by autologous BM or PBSC rescue. The conditioning regimen was well tolerated, without any toxic deaths. The median time from transplant to a neutrophil count of 0.5 × 10 9 /l was 10 days (range 6-27) and 22.5 days (range 9-114) for a plt count of 50 × 10 9 /l. Oral mucositis was recorded in 20 patients, grade 1/2 in 19 and grade 3 in the last patient. Diarrhea grade 1/2 was recorded in four patients and grade 1/2 liver toxicity in four patients. Sepsis was documented in four cases and skin toxicity in three. Lung and tubular toxicity, respectively, were reported in one patient each. We conclude that the ETC regimen presented a limited and manageable toxicity. Further studies would confirm the role of ETC in high-risk ESFT.

Original languageEnglish
Pages (from-to)1274-1280
Number of pages7
JournalBone Marrow Transplantation
Volume45
Issue number8
DOIs
Publication statusPublished - Aug 2010

Fingerprint

Thiotepa
Ewing's Sarcoma
Etoposide
Drug Therapy
Neoplasms
Stomatitis
Poisons
Tumor Burden
Diarrhea
Sepsis
Neutrophils
Necrosis
Neoplasm Metastasis
Transplants
Lung
Skin
Liver

Keywords

  • Ewings sarcoma family tumors
  • high-dose chemotherapy
  • thiotepa

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Toxicity of high-dose chemotherapy with etoposide, thiotepa and CY in treating poor-prognosis Ewing's sarcoma family tumors: The experience of the Bambino Ges Children's Hospital",
abstract = "We report the toxicity of high-dose chemotherapy (HDC) based on etoposide, thiotepa and CY (ETC) in children with poor-prognosis Ewing's sarcoma family tumors (ESFTs). A total of 26 patients with high-risk ESFT (metastasis or axis localization or tumor volume 200 ml or necrosis 95{\%}) were reviewed. The conditioning was based on etoposide (600 mg/m 2), thiotepa (750 mg/m 2) and CY (120 mg/kg) followed by autologous BM or PBSC rescue. The conditioning regimen was well tolerated, without any toxic deaths. The median time from transplant to a neutrophil count of 0.5 × 10 9 /l was 10 days (range 6-27) and 22.5 days (range 9-114) for a plt count of 50 × 10 9 /l. Oral mucositis was recorded in 20 patients, grade 1/2 in 19 and grade 3 in the last patient. Diarrhea grade 1/2 was recorded in four patients and grade 1/2 liver toxicity in four patients. Sepsis was documented in four cases and skin toxicity in three. Lung and tubular toxicity, respectively, were reported in one patient each. We conclude that the ETC regimen presented a limited and manageable toxicity. Further studies would confirm the role of ETC in high-risk ESFT.",
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author = "I. Ilari and {De Ioris}, {M. A.} and Milano, {G. M.} and R. Pessolano and {De Lurentis}, C. and {De Sio}, L. and P. Fidani and A. Jenkner and R. Cozza",
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T1 - Toxicity of high-dose chemotherapy with etoposide, thiotepa and CY in treating poor-prognosis Ewing's sarcoma family tumors

T2 - The experience of the Bambino Ges Children's Hospital

AU - Ilari, I.

AU - De Ioris, M. A.

AU - Milano, G. M.

AU - Pessolano, R.

AU - De Lurentis, C.

AU - De Sio, L.

AU - Fidani, P.

AU - Jenkner, A.

AU - Cozza, R.

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N2 - We report the toxicity of high-dose chemotherapy (HDC) based on etoposide, thiotepa and CY (ETC) in children with poor-prognosis Ewing's sarcoma family tumors (ESFTs). A total of 26 patients with high-risk ESFT (metastasis or axis localization or tumor volume 200 ml or necrosis 95%) were reviewed. The conditioning was based on etoposide (600 mg/m 2), thiotepa (750 mg/m 2) and CY (120 mg/kg) followed by autologous BM or PBSC rescue. The conditioning regimen was well tolerated, without any toxic deaths. The median time from transplant to a neutrophil count of 0.5 × 10 9 /l was 10 days (range 6-27) and 22.5 days (range 9-114) for a plt count of 50 × 10 9 /l. Oral mucositis was recorded in 20 patients, grade 1/2 in 19 and grade 3 in the last patient. Diarrhea grade 1/2 was recorded in four patients and grade 1/2 liver toxicity in four patients. Sepsis was documented in four cases and skin toxicity in three. Lung and tubular toxicity, respectively, were reported in one patient each. We conclude that the ETC regimen presented a limited and manageable toxicity. Further studies would confirm the role of ETC in high-risk ESFT.

AB - We report the toxicity of high-dose chemotherapy (HDC) based on etoposide, thiotepa and CY (ETC) in children with poor-prognosis Ewing's sarcoma family tumors (ESFTs). A total of 26 patients with high-risk ESFT (metastasis or axis localization or tumor volume 200 ml or necrosis 95%) were reviewed. The conditioning was based on etoposide (600 mg/m 2), thiotepa (750 mg/m 2) and CY (120 mg/kg) followed by autologous BM or PBSC rescue. The conditioning regimen was well tolerated, without any toxic deaths. The median time from transplant to a neutrophil count of 0.5 × 10 9 /l was 10 days (range 6-27) and 22.5 days (range 9-114) for a plt count of 50 × 10 9 /l. Oral mucositis was recorded in 20 patients, grade 1/2 in 19 and grade 3 in the last patient. Diarrhea grade 1/2 was recorded in four patients and grade 1/2 liver toxicity in four patients. Sepsis was documented in four cases and skin toxicity in three. Lung and tubular toxicity, respectively, were reported in one patient each. We conclude that the ETC regimen presented a limited and manageable toxicity. Further studies would confirm the role of ETC in high-risk ESFT.

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