Proposed strategy for the use of high-dose chemotherapy with stem cell rescue and intrathecal topotecan without whole-brain irradiation for infantile classic medulloblastoma.

Abstract

We describe a 6-month-old infant with classic medulloblastoma. Gross total resection of the left cerebellar tumor was performed; however, relapse occurred during the administration of intrathecal and intravenous methotrexate-based chemotherapy. After undergoing resection, high-dose chemotherapy was administered consisting of topotecan, melphalan, and cyclophosphamide with autologous peripheral stem cell rescue followed by local irradiation and intrathecal topotecan, which resulted in a complete response for more than two years. The administration of high-dose chemotherapy followed by intrathecal topotecan as maintenance therapy is an effective strategy, without losses in the cognitive function, for avoiding the use of whole-brain irradiation for infantile classic medulloblastoma.

• Authors: Ai Yamada, Hiroshi Moritake, Sachiyo Kamimura, Shinji Yamashita, Hideo Takeshima, Hiroyuki Nunoi
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 61 Issue 12 Pg. 2316-8 (Dec 2014) ISSN: 1545-5017 [Electronic] United States
• PMID: 25174961 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 Wiley Periodicals, Inc.

Chemical References

• Topotecan
• Cyclophosphamide
• Melphalan

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cerebellar Neoplasms (pathology, therapy)
• Combined Modality Therapy
• Cranial Irradiation
• Cyclophosphamide (administration & dosage)
• Female
• Humans
• Infant
• Injections, Spinal
• Medulloblastoma (pathology, therapy)
• Melphalan (administration & dosage)
• Neoplasm Recurrence, Local (pathology, therapy)
• Prognosis
• Stem Cell Transplantation
• Topotecan (administration & dosage)
• Transplantation, Autologous