High-dose chemotherapy and autologous hematopoietic stem-cell rescue for treatment of relapsed and refractory Wilms tumor: Re-evaluating outcomes

Pediatr Hematol Oncol. 2018 Aug-Sep;35(5-6):316-321. doi: 10.1080/08880018.2018.1532478. Epub 2019 Jan 25.

Abstract

Wilms tumor (WT) treatment regimens are curative for more than 80% of patients, but those with relapsed or refractory disease continue to have poor outcomes. High-dose chemotherapy followed by autologous stem cell rescue is often utilized although outcomes remain variable. We report on HD-ASCR outcomes in 24 patients with relapsed or refractory Wilms tumor. Three-year disease free and overall survival are 46% and 60%, respectively, which is similar to those reported for conventional salvage therapies. These outcomes suggest that conventional salvage therapies should be employed for relapsed and refractory WT rather than HD-ASCR.

Keywords: Autologous stem cell rescue; Wilms tumor; refractory; relapsed.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Autografts
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Kidney Neoplasms* / mortality
  • Kidney Neoplasms* / therapy
  • Male
  • Neoplasm Recurrence, Local* / mortality
  • Neoplasm Recurrence, Local* / therapy
  • Retrospective Studies
  • Salvage Therapy*
  • Survival Rate
  • Wilms Tumor* / mortality
  • Wilms Tumor* / therapy