1. Oct 05, 2020

High-dose chemotherapy followed by autologous stem cell transplantation beneficial in Ewing's sarcoma

The survival data of pediatric and young adult patients with metastatic/recurrent Ewing's sarcoma treated with high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) suggest the treatment may beneficial, according to a study.

In this single institution study, 47 patients with metastatic disease at diagnosis or recurrent Ewing's sarcoma were treated with high-dose chemotherapy followed by tandem (n = 20) or single (n = 27) ASCT. Those who underwent single ASCT received a novel conditioning regimen with busulfan, melphalan, and topotecan.

At 10 years and 15 years follow-up, overall survival (OS) and disease-free survival (DFS) were 46% and 37%, and 42% and 37%, respectively.

Prognostic factors in OS, DFS, and risk of relapse were disease status at transplant and the time to disease relapse prior to ASCT.

Patients transplanted in first complete response (1CR) had OS of 78% at 10 years. Patients in 1CR/2CR/first partial response (1PR) had OS of 66%; and patients at ≥3CR, ≥2PR, or advanced disease had OS of 26%.

At 10 years, patients without a history of relapse had an OS of 75%, patients with late relapse (≥2 years from diagnosis) had an OS of 50%, and patients with early relapse (<2 years from diagnosis) had an OS of 18%.

Reference
Pawlowska AB, Sun V, Calvert GT, et al. Long term follow-up of high dose chemotherapy with autologous stem cell transplantation in children and young adults with metastatic or relapsed Ewing's sarcoma – a single-institution experience. Biol Blood Marrow Transplant. 2020; DOI:https://doi.org/10.1016/j.bbmt.2020.09.029