[Megachemotherapy followed by autologous haematopoietic stem cell rescue in children with high risk CNS tumours].

Aim: the Lublin bone marrow transplantation unit experience in megachemotherapy followed by autologus haematopoietic stem cell transplantation in children with high-risk CNS tumours is described.
Material and Methods: 9 patients (8 boys and 1 girl) treated in our department between 1999-2004, with high risk malignant brain tumours were included into the study. Median age of the patients was 10 years (range 4-18 years). The group consisted of 5 cases of medulloblastoma, and single cases of ependynmoma, teratoma, astrocytoma anaplasticum and glioblastoma. Stem cell apheresis from peripheral blood was performed during chemotherapy after surgery. Megachemotherapy consisted of carboplatin in total dose 1200 mg/m2, etoposide in total dose 800mg/m2 and melphalan in total dose 200 mg/m2 in five patients. Remaining four children received carboplatin in total dose 1800 mg/m2, etoposide in total dose 750 mg/m and tiothepa in total dose 900 mg/m2.
Results: two patients relapsed one and two months after megachemotherapy respectively. No transplant related mortality was observed. Seven children are alive and well with the median observation time 23 months.
Conclusion: megachemotherapy followed by stem cell rescue is a safe and feasible procedure in children with malignant brain tumours and may improve results of the treatment in high-risk patients, but these results should be con firmed in larger series of patients.