ISSN 1866-8836
Клеточная терапия и трансплантация

PO-09. Tandem autologous transplantation of hematopoietic stem cells in children with germ cell tumors: experience of N. N. Blokhin center

Karina A. Sergeenko, Natalia A. Burlaka, Tatiana I. Potemkina, Konstantin V. Mitrakov, Teimour Z. Aliev, Irina O. Kostareva, Nara G. Stepanyan, Elena B. Machneva, Olga A. Kapkova, Marina V. Rubanskaya, Anatoly P. Kazantsev, Vladimir G. Polyakov, Kirill I. Kirgizov, Svetlana R. Varfolomeeva

L. Durnov Research Institute of Pediatric Oncology and Hematology at the N. N. Blokhin National Medical Research Centre of Oncology, Moscow, Russia


Contact: Dr. Karina A. Sergeenko, phone: +7 (977) 720-70-84, e-mail: karina_s19@mail.ru

doi 10.18620/ctt-1866-8836-2023-12-3-1-176

Summary

A special place among pediatric germ cell tumors (GCTs) is occupied by tumors of a disseminated nature and with an insufficient response to therapy (recurrent/refractory), which occupy up to 30-40% in the structure of GCTs. Autologous hematopoietic stem cell transplantation (aHSCT) in tandem mode is one of the important steps in the treatment of such cases. Our objective was to present the experience of tandem aHSCT in children with GCTs in L. A. Durnov Research Institute of Pediatric Oncology and Hematology at the N. N. Blokhin National Medical Research Center of Oncology.

Patients and methods

Eleven children with high-risk GCT (disseminated, relapsed/refractory forms) received tandem aHSCT at our center between 2021 and 2023. The median age is 4 (1-16) years. M:F ratio was 6:5. Before aHSCT, the patients received systemic chemotherapy according to the MAKEI 2005 protocol and COG-oriented protocols, as well as surgery. The conditioning regimen included Carboplatin 1200 mg/sq.m. and Etoposide 1500 mg/m2; Etoposide 1500 mg/sq.m. and Thiotepa 900 mg/sq.m. From day 0, all children underwent stimulation of leukopoiesis with granulocyte colony-stimulating factor. The median of transplanted CD34+ cells was 5.5 (4.6-7)*106/kg.

Results

Hematopoiesis was restored on average on the 12th day (9-14). Infectious and toxic complications: oropharyngeal mucositis up to grade 3, neutropenic enterocolitis up to grade 3, perianal dermatitis, toxidermia associated with Thiotepa up to grade 3. All patients are alive. Median follow-up was 12 (2-30) months.

Conclusion

Tandem aHSCT in children with high-risk GCT appears to be a safe and effective method of consolidating therapy. Complications after aHSCT were not severe. All patients are alive and are in remission. However, more experience is needed to improve treatment outcomes.

Keywords

Hematopoietic stem cell transplantation, germ cell tumors, children.


Supplement 12-3
09/30/2023

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doi 10.18620/ctt-1866-8836-2023-12-3-1-176

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