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. 2022 May 5;52(5):486-492.
doi: 10.1093/jjco/hyac007.

Outcome of children with relapsed high-risk neuroblastoma in Japan and analysis of the role of allogeneic hematopoietic stem cell transplantation

Junichi Hara  1 , Chika Nitani  1 , Hiroyuki Shichino  2 , Tatsuo Kuroda  3 , Tomoro Hishiki  4 , Toshinori Soejima  5 , Tetsuya Mori  6 , Kimikazu Matsumoto  7 , Yoji Sasahara  8 , Tomoko Iehara  9 , Takako Miyamura  10 , Yoshiyuki Kosaka  11 , Tetsuya Takimoto  12 , Akira Nakagawara  13 , Tatsuro Tajiri  14   15 ; Japan Children’s Cancer Group (JCCG) Neuroblastoma Committee (JNBSG)
Affiliations

Outcome of children with relapsed high-risk neuroblastoma in Japan and analysis of the role of allogeneic hematopoietic stem cell transplantation

Junichi Hara et al. Jpn J Clin Oncol. .

Abstract

Background: In Japan, allogeneic hematopoietic stem cell transplantation is widely performed for recurrent neuroblastomas. This retrospective study aimed to investigate the prognosis of recurrent neuroblastoma in Japan and explore the effectiveness of allogeneic hematopoietic stem cell transplantation.

Methods: Clinical characteristics and data on the treatment of patients with high-risk neuroblastoma who experienced first progression between 2003 and 2010 after attaining complete remission or partial remission were collected from hospitals participating in the Japanese Neuroblastoma Research Group.

Results: Data from 61 patients who fulfilled these criteria were collected. The median interval from disease onset to first progression was 19 months (range, 7-65 months), whereas the median observation time of the surviving patients was 18 months (range, 1-69 months). All patients were treated with chemotherapy, where 22 and 3 patients received allogeneic and autologous hematopoietic stem cell transplantation, respectively. Seven patients were alive in second complete remission, and 39 died, including two in complete remission. The 3-year progression-free survival and overall survival rates were 15.3% (SE: 6.1%) and 16.9% (SE: 6.5%), respectively. For patients with allogeneic hematopoietic stem cell transplantation, the 3-year progression-free survival and overall survival were 28.3% (standard error, 12.0%) and 24.3% (standard error, 11.5%), respectively, and for patients without allogeneic hematopoietic stem cell transplantation, the 3-year progression-free survival and overall survival were 6.0% (standard error 5.5%) and 12.0% (standard error 7.6%), respectively. The duration of initial remission (≥ 18 months) and implementation of allogeneic hematopoietic stem cell transplantation were independently predictive of progression-free survival (P = 0.002 and P = 0.017), whereas for overall survival, only allogeneic hematopoietic stem cell transplantation was predictive (P = 0.012).

Conclusion: Although allogeneic hematopoietic stem cell transplantation contributed to some improvement in prognosis, it was insufficient.

Keywords: allogeneic hematopoietic stem cell transplantation; neuroblastoma; relapse.

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