Two-Year Report on Hematopoietic Stem Cell Transplantation for Patients with Wilms’ Tumor in the Pediatric Center of Excellence of Iran
- سال انتشار: 1397
- محل انتشار: سومین جشنواره ملی و کنگره بین المللی علوم و فناوری های سلول های بنیادی و پزشکی بازساختی
- کد COI اختصاصی: NSCMRMED03_290
- زبان مقاله: انگلیسی
- تعداد مشاهده: 425
نویسندگان
School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Pediatric Stem Cell Transplantation, Children’s Medical Center, Tehran University of Medical Sciences,Tehran, Iran
Pediatric Urology and Regenerative Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
Cell-Based Therapies Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences,Tehran, Iran
چکیده
Background and Aim: Wilms’ Tumor (WT) is known as the most commonpediatric malignancy of the kidney. The majority of patients respondto tumor resection and standard chemotherapy. Relapse, however,is associated with poor prognosis leading to the 4-year survival ofapproximately 50%. For patients who experience relapse, high dosechemotherapy (myeloablative) followed by autologous hematopoieticstem cell transplantation (auto-HSCT) is a recommended clinical option.Here, we report the outcome of a series of relapsed WT patients treatedwith auto-HSCT.Methods: The HSCT department of Children’s Medical Center, knownas the largest children’s hospital in Iran and the country’s pediatriccenter of excellence, has been established since September 2016. Inthis retrospective study, epidemiologic profile of relapsed WT patientsundergoing myeloablative conditioning regimen (busulfan pluscyclophosphamide) followed by auto-HSCT, from Sep 2016 to Sep 2018,is reported. In addition, treatment details and outcomes are presented.Results: During the two-year period, 188 patients with various diseasesunderwent HSCT (both allogeneic and autologous) in the department, ofwhom, four relapsed WT patients (2.1% of all patients) with a medianage of 5.5 (range, 3-7) years were treated with auto-HSCT. Three patientswere female. HSCT graft was obtained from peripheral blood employingG-CSF mobilization. The median number of cells infused in HSCT was 15× 108/kg WBCs, 7.5 × 108/kg mononuclear cells, and 3.3 × 106/kg CD34+cells. After the procedure, all patients achieved hematologic engraftmentas well as full chimerism according to short tandem repeat analysis. Themedian times to granulocyte engraftment and platelet recovery were 10days and 11 days, respectively. No cytomegalovirus infection and graftfailure occurred. The median length of hospital stay was 25 days. Up tothe end of the study period, all patients were alive and relapse occurredin only 1 patient.Conclusion: Despite the remarkable improvement in the overall survivalof WT patients, the prognosis of relapsed WT patients has remaineddisappointing. In such patients, the long-term outcomes have improveddramatically with the advent of adjusted myeloablative conditioningregimens followed by auto-HSCT. Our study provides further evidencefor favorable outcomes following myeloablative auto-HSCT in relapsedWT patients.کلیدواژه ها
Hematopoietic Stem Cell Transplantation; Wilms’ Tumor; MAC Conditioning regimenمقالات مرتبط جدید
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