Thursday, 25 April 2013

Neuroblastoma regimen employed in Europe and Egypt less toxic than the one used in U.S.

Yesterday, we reported on a study by researchers at the Dana-Farber Children's Hospital Cancer Centre, Boston (DF/CHCC) which revealed that the majority of children readmit to hospital after receiving a stem cell transplant. At the same time, DF/CHCC researchers presented another study which shows that the stem cell transplant regimen used in the U.S. for advanced neuroblastoma in children is more toxic, although equally effective, than the busulfan-based regimen used in Egypt and many European countries.

The typical approach followed by physicians at DF/CHCC and other U.S. hospitals to treat neuroblastoma is to first kill cancer cells using chemotherapy, comprised of the following drugs:
  • Carboplatin
  • Etoposide
  • Melphalan

Then the patient receives a stem cell transplant in order to have a quick and safe recovery.

MRI showing neuroblastoma in a 2 year old patient

In this study the researchers, led by Yasser Elborai,, found that their chemotherapy was more toxic to the kidneys and liver than the one used by their colleagues over the Children's Cancer Hospital Egypt in Cairo

"We have had a long-standing collaboration with Children's Cancer Hospital Egypt in Cairo, which is under the leadership of senior author Dr. Alaa Elhaddad, we decided to compare the toxicities in patients who received care that was very similar except for the drugs used in the preparative regimen." explained Leslie Lehmann, senior author of the study.

Despite of the higher toxicity, both regimens have the same survival ratio.

"We found there was no difference in survival, but our regimen was associated with more liver and kidney toxicity and more bloodstream infections," said Lehmann. 

Neuroblastoma is the most common extracranial solid cancer in children and infants, with an average incidence of about 650 cases per year in the U.S. and 100 cases per year in the U.K. 

What is neuroblastoma, by Dr. Justin David

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