HG-54THE ROLE OF HIGH-DOSE MYELOABLATIVE CHEMOTHERAPY (HDCT) WITH HAEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) IN CHILDREN WITH HIGH GRADE GLIOMAS (HGG) OR DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG): RESULTS OF A SYSTEMATIC REVIEW

Abstract

HG-54. THE ROLE OF HIGH-DOSE MYELOABLATIVE CHEMOTHERAPY (HDCT) WITH HAEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) IN CHILDREN WITH HIGH GRADE GLIOMAS (HGG) OR DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG): RESULTS OF A SYSTEMATIC REVIEW Caroline Main1, Madeline Adams2, Katherine Cooper3, Sophie Wilne4, Bob Phillips5, Martin English6, Pamela R. Kearns1,6, Barry Pizer3, Simon P. Stevens1, Keith Wheatley1, and Jayne S. Wilson1; Cancer Research UK Clinical Trials Unit; University of Birmingham, Birmingham, UK; Bristol Children’s Hospital, Bristol, UK; Alder Hey Children’s NHS Foundation Trust, Liverpool, UK; Nottingham University Hospitals’ NHS Trust, Nottingham, UK; UK Centre for Reviews and Dissemination, University of York, UK; Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK OBJECTIVES: To assess the impact of HDCT/HSCT in children with HGG or DIPG. METHODS: Ten electronic databases were searched from 1985 to Oct 2015 for studies assessing HDCT/HSCT in HGG and DIPG. Outcomes included overall survival (OS), response rates (RR), adverse events and treatment related mortality (TRM). Standard systematic review methods were used to minimise bias. RESULTS: For HGG, 167 patients were included, 56% newly diagnosed and 44% relapsed. Mean age was 8.7 years. Mean follow-up was 2.8-years (range: 0.2-5.4). HDCT mainly consisted of one cycle, with preor post radiotherapy (RT) used in 59% of patients. Median OS for newly diagnosed HGG was between 9-14 months (range: 1-65) (n 1⁄4 27), with one and four year OS 73%+13% (n 1⁄4 11) and 43% (n 1⁄4 21) respectively. Overall RR was 30% (n 1⁄4 26). For relapsed HGG median OS was 12.7months (n 1⁄4 18). Across the studies nine TRM occurred. Sixty-two patients with DIPG were included, 68% newly diagnosed and 32% relapsed. Mean age was 6.8-years. Median follow-up was 1.5 years (range: 0.1-7). HDCT consisted of one cycle, with 77% patients receiving prior RT. For newly diagnosed patients with DIPG, median OS was 10-11.4 months (range: 6.4-17.1) (n 1⁄4 42), and for relapsed patients 4.8 months (0.1-18.7) (n 1⁄4 16). Across the studies five toxicity related deaths occurred (8%). CONCLUSIONS: The limited evidence on HDCT/HSCT in children with HGG or DIPG does not allow reliable conclusions to be drawn. However, use of HDCT/HSCT in these patient groups is associated with a significant toxicity profile and TRM. Neuro-Oncology 18:iii48–iii77, 2016. doi:10.1093/neuonc/now073.50 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.