Since May 1979, 47 patients with pediatric
malignancy aged 1 to 18 years (median: 7) were treated with cryopreserved autologous
bone marrow transplantation (ABMT) in the department of pediatrics, National
Cancer Center Hospital. The
malignancies were acute non-
lymphocytic leukemia (n = 8),
acute lymphocytic leukemia (n = 5),
osteosarcoma (n = 7),
neuroblastoma (n = 6),
brain tumor (n = 5),
rhabdomyosarcoma (n = 4),
retinoblastoma (n = 3),
Ewing's sarcoma (n = 3),
non-Hodgkin's lymphoma (n = 2),
malignant histiocytosis (n = 1),
hepatoblastoma (n = 1),
malignant melanoma (n = 1) and malignant neuroepithelioma (n = 1). Conditioning regimens for solid
tumors were multi-agent high-dose
chemotherapy, mainly consisted of
cyclophosphamide (CY) 120 mg/kg or
melphalan 180mg/m2 and that for
hematological malignancies were CY with fractionated total body irradiation (12 Gy). In vitro purging by
4-hydroperoxycyclophosphamide was performed in 12
leukemia patients and 5 solid
tumor patients. Of the 13 patients with acute
leukemia, 1 died from relapse 1 year after the unpurged marrow
transplantation and 1 relapsed in the testis. Remaining 11 patients are alive in continuous complete remission with a median follow up of 30 months (range, 2 to 65 months) after
transplantation. The disease-free survival rate of them was 78%. Of the 34 patients with solid
tumor, 21 patients died, their cause of death were relapse in 18 and each one of
infection, graft failure and
brain hemorrhage. Thirteen patients are alive without disease with a median follow up of 28 months (range, 2 to 107 months) posttransplant. The longest survivor is a
brain tumor girl, and there are 5 other long survivors; 2 of them are
osteosarcoma and each one of
rhabdomyosarcoma,
Ewing's sarcoma and
malignant histiocytosis. The disease-free survival rate of total 34 solid
tumor patients is 29%, but that of 17 patients who received ABMT in responsive and minimum
tumor residue (MTR) period was 69%. These results suggest that autologous
bone marrow transplantation is an effective and tolerable treatment for poor prognostic pediatric
malignancies, especially for acute
leukemia and such solid
tumor as that in MTR state.