In this study, the newly developed marrow-rescue
therapy during myelosuppression is utilized. In this
therapy, peripheral blood stem cell transfusion (PBSCT) is administered following high-dose
chemotherapy. Harvest of peripheral blood stem cells (PBSC) during myelosuppression following marrow-ablative
chemotherapy is a safe, reliable procedure in children with
leukemia. And administration of these cryopreserved PBSC is useful in reducing myelosuppression following intensive/ultra high-dose
chemotherapy. In this study, several courses of intensive
chemotherapy (1 course:
VP-16 300mg/m2 x 5 days +
carboplatin 400-500mg/m2 x 3 days) and one course of ultra-high dose
chemotherapy (1 course:
VP-16 400mg/m2 x 8 days +
carboplatin 800mg/m2 x 5 days +
MCNU 250, 200mg/m2 x each day) with PBSC transfusion were applied in four cases of pediatric malignant
brain tumors (2 cases of
medulloblastoma, one case of
pineoblastoma and
anaplastic ependymoma) after surgical reduction. With PBSC transfusion, myelosuppression following high-dose
chemotherapy could be overcome without serious complication in all cases. Three cases showed complete remission and one showed partial remission after the operation and intensive
chemotherapy. However, CSF dissemination appeared in two cases and they died 20 and 28 months after the onset respectively. Intensive/ultra high-dose
chemotherapy with PBSC transfusion is a safe procedure in children with malignant
brain tumors. This procedure may enable the postponement of radiation for pediatric malignant
brain tumor cases under three years of age.