Skip to main content
eScholarship
Open Access Publications from the University of California

Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: a CIBMTR retrospective analysis.

  • Author(s): Malogolowkin, MH
  • Hemmer, MT
  • Le-Rademacher, J
  • Hale, GA
  • Mehta, PA
  • Smith, AR
  • Kitko, C
  • Abraham, A
  • Abdel-Azim, H
  • Dandoy, C
  • Angel Diaz, M
  • Gale, RP
  • Guilcher, G
  • Hayashi, R
  • Jodele, S
  • Kasow, KA
  • MacMillian, ML
  • Thakar, M
  • Wirk, BM
  • Woolfrey, A
  • Thiel, EL
  • et al.
Abstract

Despite the marked improvement in the overall survival (OS) for patients diagnosed with Wilms' tumor (WT), the outcomes for those who experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and were reported to the Center for International Blood and Marrow Transplantation Research. The 5-year estimates for event-free survival (EFS) and OS were 36% (95% confidence interval (CI); 29-43%) and 45% (95 CI; 38-51%), respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. As attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus HDT followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. As disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
Current View