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Multicenter Study
. 2008 May;41(10):867-72.
doi: 10.1038/bmt.2008.2. Epub 2008 Feb 4.

Myeloablative therapy with autologous stem cell rescue for patients with Ewing sarcoma

S L Gardner  1 , J Carreras, C Boudreau, B M Camitta, R H Adams, A R Chen, S M Davies, J R Edwards, A C Grovas, G A Hale, H M Lazarus, M Arora, P J Stiff, M Eapen
Affiliations
Multicenter Study

Myeloablative therapy with autologous stem cell rescue for patients with Ewing sarcoma

S L Gardner et al. Bone Marrow Transplant. 2008 May.

Abstract

The aim of this study was to identify risk factors associated with PFS in patients with Ewing sarcoma undergoing ASCT; 116 patients underwent ASCT in 1989-2000 and reported to the Center for International Blood and Marrow Transplant Research. Eighty patients (69%) received ASCT as first-line therapy and 36 (31%), for recurrent disease. Risk factors affecting ASCT were analyzed with use of the Cox regression method. Metastatic disease at diagnosis, recurrence prior to ASCT and performance score <90 were associated with higher rates of disease recurrence/progression. Five-year probabilities of PFS in patients with localized and metastatic disease at diagnosis who received ASCT as first-line therapy were 49% (95% CI 30-69) and 34% (95% CI 22-47) respectively. The 5-year probability of PFS in patients with localized disease at diagnosis, and received ASCT after recurrence was 14% (95% CI 3-30). PFS rates after ASCT are comparable to published rates in patients with similar disease characteristics treated with conventional chemotherapy, surgery and irradiation suggesting a limited role for ASCT in these patients. Therefore, ASCT if considered should be for high-risk patients in the setting of carefully controlled clinical trials.

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Figures

Figure 1
Figure 1
Probability of progression-free survival (PFS) after ASCT by disease stage and disease status: A=patients with local disease and received ASCT as first line therapy (49% @ 5 years); B=patients with metastatic disease and received ASCT as first line therapy (34% @ 5 years) and C=patients with local disease and received ASCT after recurrence (14% @ 5 years).
Figure 2
Figure 2
Probability of overall survival (OS) after ASCT by disease stage and disease status: A=patients with local disease and received ASCT as first line therapy (52% @ 5 years); B=patients with metastatic disease and received ASCT as first line therapy (39% @ 5 years) and C=patients with local disease and received ASCT after recurrence (22% @ 5 years).
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