© Copyright 2006 by the Society for Neuro-Oncology
Received July 22, 2005
Accepted December 19, 2005
High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma: Long-term follow-up
Lauren E. Abrey 1*,
Barrett H. Childs 1,
Nina Paleologos 2,
Lynne Kaminer 2,
Steven Rosenfeld 3,
Donna Salzman 3,
Jonathan L. Finlay 4,
Sharon Gardner 4,
Kendra Peterson 5,
Wendy Hu 5,
Lode Swinnen 6,
Robert Bayer 6,
Peter Forsyth 7,
Douglas Stewart 7,
Anne M. Smith 8,
David R. Macdonald 9,
Susan Weaver 10,
David A. Ramsay 9,
Stephen D. Nimer 11,
Lisa M. DeAngelis 11,
J. Gregory Cairncross 9
1 Department of Neurology, Memorial Sloan-Kettering Cancer Center
2 Northwestern University
3 University of Alabama, Birmingham
4 New York University
5 Stanford University Medical Center
6 Loyola University Medical Center, Maywood, IL
7 University of Calgary
8 Kingston Regional Cancer Centre, Kingston, ON
9 London Regional Cancer Centre
10 Albany Medical College
11 Memorial Sloan-Kettering Cancer Center
* To whom correspondence should be addressed. E-mail: abreyl{at}mskcc.org.
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Abstract |
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We previously reported a phase 2 trial of 69 patients with newly diagnosed anaplastic or aggressive oligodendroglioma who were treated with intensive procarbazine, CCNU (lomustine), and vincristine (PCV) followed by high-dose thiotepa with autologous stem cell rescue. This report summarizes the long-term follow-up of the cohort of 39 patients who received high-dose thiotepa with autologous stem cell support. Thirty-nine patients with a median age of 43 (range, 18-67) and a median KPS of 100 (range, 70-100) were treated. Surviving patients now have a median follow-up of 80.5 months (range, 44-142). The median progression-free survival is 78 months, and median overall survival has not been reached. Eighteen patients (46%) have relapsed. Neither histology nor prior low-grade oligodendroglioma correlated with risk of relapse. Persistent nonenhancing tumor at transplant was identified in our initial report as a significant risk factor for relapse; however, long-term follow-up has not confirmed this finding. Long-term neurotoxicity has developed only in those patients whose disease relapsed and required additional therapy; no patient in continuous remission has developed a delayed neurologic injury. This treatment strategy affords long-term disease control to a subset of patients with newly diagnosed anaplastic oligodendroglioma without evidence of delayed neurotoxicity or myelodysplasia.
Key Words:
anaplastic, chemotherapy, oligodendroglioma
