High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma

Lauren E. Abrey, Barrett H. Childs, Nina Paleologos, Lynne Kaminer, Steven Rosenfeld, Donna Salzman, Jonathan L. Finlay, Sharon Gardner, Kendra Peterson, Wendy Hu, Lode Swinnen, Robert Bayer, Peter Forsyth, Douglas Stewart, Anne M. Smith, David R. Macdonald, Susan Weaver, David A. Ramsey, Stephen D. Nimer, Lisa M. DeAngelis & 1 others J. Gregory Cairncross

Research output: Contribution to journalArticle

Abstract

Purpose: Anaplastic oligodendroglioma is a chemosensitive glial neoplasm. To improve disease control and postpone cranial radiotherapy, we designed a phase II study of intensive procarbazine, lomunstine and vincristine followed by high-dose thiotepa with autologous stem cell rescue for patients with newly diagnosed anaplastic or aggressive oligodendroglioma. Patients and methods: Sixty-nine patients with a median age of 42 (range: 18-67) and a median Karnofsky Performance Score of 90 (range: 70-100) were enrolled. Sixteen patients had a prior diagnosis of low-grade oligodendroglioma and 16 had mixed oligoastrocytoma pathology. Only patients with demonstrably chemosensitive enhancing tumors or those free of enhancing tumor after surgery and induction therapy were eligible to receive high-dose thiotepa. Results: Thirty-nine patients (57%) completed the transplant regimen; their estimated median progression-free survival is 69 months and median overall survival has not been reached. Twelve transplanted patients (31 %) relapsed. Neither histology nor prior low-grade oligodendroglioma correlated with relapse; however, persistent non-enhancing tumor at transplant conferred an increased risk of relapse (p = 0.028). The transplant regimen was well-tolerated; median hospital stay was 20 days (range: 7-43) with a median time to ANC and platelet engraftment of 10 days. Thirty patients (43%) did not receive high-dose thiotepa because of stable or progressive disease (n = 21), excessive toxicity (n = 4), refusal of further therapy (n = 2), failure to obtain insurance coverage (n = 2), or other (n - 1). No treatment-related or long-term neurotoxicity was seen in the transplanted patients. Conclusions: High-dose chemotherapy with stem cell rescue as initial treatment for anaplastic oligodendroglioma is feasible and associated with prolonged tumor control in some patients.

Original languageEnglish (US)
Pages (from-to)127-134
Number of pages8
JournalJournal of Neuro-Oncology
Volume65
Issue number2
DOIs
StatePublished - Nov 2003
Externally publishedYes

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Oligodendroglioma
Stem Cells
Drug Therapy
Thiotepa
Therapeutics
Neoplasms
Transplants
Procarbazine
Recurrence
Insurance Coverage
Astrocytoma
Vincristine
Neuroglia
Disease-Free Survival
Length of Stay
Histology
Radiotherapy
Blood Platelets
Pathology

Keywords

  • Anaplastic
  • Chemotherapy
  • Oligodendroglioma

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neuroscience(all)

Cite this

Abrey, L. E., Childs, B. H., Paleologos, N., Kaminer, L., Rosenfeld, S., Salzman, D., ... Cairncross, J. G. (2003). High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma. Journal of Neuro-Oncology, 65(2), 127-134. https://doi.org/10.1023/B:NEON.0000003645.82791.2a

High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma. / Abrey, Lauren E.; Childs, Barrett H.; Paleologos, Nina; Kaminer, Lynne; Rosenfeld, Steven; Salzman, Donna; Finlay, Jonathan L.; Gardner, Sharon; Peterson, Kendra; Hu, Wendy; Swinnen, Lode; Bayer, Robert; Forsyth, Peter; Stewart, Douglas; Smith, Anne M.; Macdonald, David R.; Weaver, Susan; Ramsey, David A.; Nimer, Stephen D.; DeAngelis, Lisa M.; Cairncross, J. Gregory.

In: Journal of Neuro-Oncology, Vol. 65, No. 2, 11.2003, p. 127-134.

Research output: Contribution to journalArticle

Abrey, LE, Childs, BH, Paleologos, N, Kaminer, L, Rosenfeld, S, Salzman, D, Finlay, JL, Gardner, S, Peterson, K, Hu, W, Swinnen, L, Bayer, R, Forsyth, P, Stewart, D, Smith, AM, Macdonald, DR, Weaver, S, Ramsey, DA, Nimer, SD, DeAngelis, LM & Cairncross, JG 2003, 'High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma', Journal of Neuro-Oncology, vol. 65, no. 2, pp. 127-134. https://doi.org/10.1023/B:NEON.0000003645.82791.2a
Abrey, Lauren E. ; Childs, Barrett H. ; Paleologos, Nina ; Kaminer, Lynne ; Rosenfeld, Steven ; Salzman, Donna ; Finlay, Jonathan L. ; Gardner, Sharon ; Peterson, Kendra ; Hu, Wendy ; Swinnen, Lode ; Bayer, Robert ; Forsyth, Peter ; Stewart, Douglas ; Smith, Anne M. ; Macdonald, David R. ; Weaver, Susan ; Ramsey, David A. ; Nimer, Stephen D. ; DeAngelis, Lisa M. ; Cairncross, J. Gregory. / High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma. In: Journal of Neuro-Oncology. 2003 ; Vol. 65, No. 2. pp. 127-134.
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abstract = "Purpose: Anaplastic oligodendroglioma is a chemosensitive glial neoplasm. To improve disease control and postpone cranial radiotherapy, we designed a phase II study of intensive procarbazine, lomunstine and vincristine followed by high-dose thiotepa with autologous stem cell rescue for patients with newly diagnosed anaplastic or aggressive oligodendroglioma. Patients and methods: Sixty-nine patients with a median age of 42 (range: 18-67) and a median Karnofsky Performance Score of 90 (range: 70-100) were enrolled. Sixteen patients had a prior diagnosis of low-grade oligodendroglioma and 16 had mixed oligoastrocytoma pathology. Only patients with demonstrably chemosensitive enhancing tumors or those free of enhancing tumor after surgery and induction therapy were eligible to receive high-dose thiotepa. Results: Thirty-nine patients (57{\%}) completed the transplant regimen; their estimated median progression-free survival is 69 months and median overall survival has not been reached. Twelve transplanted patients (31 {\%}) relapsed. Neither histology nor prior low-grade oligodendroglioma correlated with relapse; however, persistent non-enhancing tumor at transplant conferred an increased risk of relapse (p = 0.028). The transplant regimen was well-tolerated; median hospital stay was 20 days (range: 7-43) with a median time to ANC and platelet engraftment of 10 days. Thirty patients (43{\%}) did not receive high-dose thiotepa because of stable or progressive disease (n = 21), excessive toxicity (n = 4), refusal of further therapy (n = 2), failure to obtain insurance coverage (n = 2), or other (n - 1). No treatment-related or long-term neurotoxicity was seen in the transplanted patients. Conclusions: High-dose chemotherapy with stem cell rescue as initial treatment for anaplastic oligodendroglioma is feasible and associated with prolonged tumor control in some patients.",
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T1 - High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma

AU - Abrey, Lauren E.

AU - Childs, Barrett H.

AU - Paleologos, Nina

AU - Kaminer, Lynne

AU - Rosenfeld, Steven

AU - Salzman, Donna

AU - Finlay, Jonathan L.

AU - Gardner, Sharon

AU - Peterson, Kendra

AU - Hu, Wendy

AU - Swinnen, Lode

AU - Bayer, Robert

AU - Forsyth, Peter

AU - Stewart, Douglas

AU - Smith, Anne M.

AU - Macdonald, David R.

AU - Weaver, Susan

AU - Ramsey, David A.

AU - Nimer, Stephen D.

AU - DeAngelis, Lisa M.

AU - Cairncross, J. Gregory

PY - 2003/11

Y1 - 2003/11

N2 - Purpose: Anaplastic oligodendroglioma is a chemosensitive glial neoplasm. To improve disease control and postpone cranial radiotherapy, we designed a phase II study of intensive procarbazine, lomunstine and vincristine followed by high-dose thiotepa with autologous stem cell rescue for patients with newly diagnosed anaplastic or aggressive oligodendroglioma. Patients and methods: Sixty-nine patients with a median age of 42 (range: 18-67) and a median Karnofsky Performance Score of 90 (range: 70-100) were enrolled. Sixteen patients had a prior diagnosis of low-grade oligodendroglioma and 16 had mixed oligoastrocytoma pathology. Only patients with demonstrably chemosensitive enhancing tumors or those free of enhancing tumor after surgery and induction therapy were eligible to receive high-dose thiotepa. Results: Thirty-nine patients (57%) completed the transplant regimen; their estimated median progression-free survival is 69 months and median overall survival has not been reached. Twelve transplanted patients (31 %) relapsed. Neither histology nor prior low-grade oligodendroglioma correlated with relapse; however, persistent non-enhancing tumor at transplant conferred an increased risk of relapse (p = 0.028). The transplant regimen was well-tolerated; median hospital stay was 20 days (range: 7-43) with a median time to ANC and platelet engraftment of 10 days. Thirty patients (43%) did not receive high-dose thiotepa because of stable or progressive disease (n = 21), excessive toxicity (n = 4), refusal of further therapy (n = 2), failure to obtain insurance coverage (n = 2), or other (n - 1). No treatment-related or long-term neurotoxicity was seen in the transplanted patients. Conclusions: High-dose chemotherapy with stem cell rescue as initial treatment for anaplastic oligodendroglioma is feasible and associated with prolonged tumor control in some patients.

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