Bone marrow metastases at diagnosis in children and adolescents with rhabdomyosarcoma. A report from the intergroup rhabdomyosarcoma study

Cancer. 1984 Jan 15;53(2):368-73. doi: 10.1002/1097-0142(19840115)53:2<368::aid-cncr2820530233>;2-3.


Thirty children and adolescents with rhabdomyosarcoma (RMS) entered on IRS-1 in a 5-year period had bone marrow metastases (BMM) at diagnosis. BMM at diagnosis occurred in 30/103 patients (29%) with Clinical Group IV RMS. On the average, patients with BMM were older with more extremity primaries than other IRS-1 patients. Alveolar histology was present in 15/30 patients (50%) with BMM, compared to 19% on IRS-1. Eleven patients received vincristine, dactinomycin, cyclophosphamide (VAC), while 19 patients received VAC with Adriamycin (ADR). The overall complete response (CR) rate was 60%. The median disease-free survival times by treatment were 17 weeks with VAC and 32 weeks for VAC + ADR (P greater than 0.10). Relapse from CR in Clinical Group IV patients with BMM occurred in 16/18 patients (89%) and was significantly higher than in 17/29 Clinical Group IV patients (59%) without BMM (P less than 0.035). BMM at diagnosis in children and adolescents with RMS is frequently associated with alveolar histology and is a poor prognostic sign.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bone Marrow Diseases / drug therapy*
  • Bone Neoplasms / drug therapy*
  • Child
  • Child, Preschool
  • Cyclophosphamide / administration & dosage
  • Dactinomycin / administration & dosage
  • Doxorubicin / administration & dosage
  • Extremities
  • Female
  • Humans
  • Infant
  • Male
  • Prognosis
  • Registries
  • Rhabdomyosarcoma / drug therapy*
  • Rhabdomyosarcoma / pathology
  • Time Factors
  • Vincristine / administration & dosage


  • Dactinomycin
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide

Supplementary concepts

  • VAC protocol