Recurrent disseminated retinoblastoma treated by high-dose chemotherapy, total body irradiation, and autologous bone marrow rescue

Am J Pediatr Hematol Oncol. Fall 1991;13(3):315-9. doi: 10.1097/00043426-199123000-00012.

Abstract

A case of recurrent, disseminated retinoblastoma is presented. The primary intraocular tumor, a metastatic mass at recurrence, and the tumor cells infiltrating bone marrow were all positive for the anti-GD2 monoclonal antibody (Mab) 3A7. Indirect immunofluorescence using the monoclonal antibody 3A7 was an effective method of detecting residual disease in the marrow. After remission was achieved by conventional therapy, the patient underwent autologous bone marrow transplantation (ABMT). The preparative regimen consisted of VP-16, cisplatinum, high-dose melphalan, and total body irradiation. The autologous marrow inoculum was clean of tumor cells at the detection level of 1:10,000. The transplant course was uneventful, and the patient is well and disease-free 17 months after ABMT. We conclude that high-dose chemotherapy and total body irradiation in an ABMT setting is feasible and a potentially curative approach to disseminated retinoblastoma.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / immunology*
  • Antigens, Neoplasm / analysis*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / immunology*
  • Bone Marrow / pathology
  • Bone Marrow Purging
  • Bone Marrow Transplantation*
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / secondary
  • Bone Neoplasms / surgery
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Etoposide / administration & dosage
  • Eye Enucleation
  • Eye Neoplasms / pathology*
  • Eye Neoplasms / surgery
  • Female
  • Gangliosides / immunology*
  • Humans
  • Mandibular Neoplasms / drug therapy
  • Mandibular Neoplasms / radiotherapy
  • Mandibular Neoplasms / secondary*
  • Mandibular Neoplasms / surgery
  • Methotrexate / administration & dosage
  • Neoplasm Recurrence, Local
  • Neoplastic Stem Cells / immunology
  • Neoplastic Stem Cells / pathology
  • Remission Induction
  • Retinoblastoma / drug therapy
  • Retinoblastoma / immunology
  • Retinoblastoma / radiotherapy
  • Retinoblastoma / secondary*
  • Retinoblastoma / surgery
  • Transplantation, Autologous
  • Vincristine / administration & dosage
  • Whole-Body Irradiation*

Substances

  • Antibodies, Monoclonal
  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Gangliosides
  • Vincristine
  • ganglioside, GD2
  • Etoposide
  • Cyclophosphamide
  • Cisplatin
  • Methotrexate