High-dose chemotherapy with autologous peripheral blood stem cell transplantation for bone and soft-tissue sarcomas

The role of high-dose chemotherapy (HDCT) with PBSCT in the treatment of bone and soft-tissue sarcomas is not established. In total, 27 patients ( 15 female, median age at TPL 30.6 years ( range: 13 - 59)) were analyzed ( Ewing sarcoma family n = 8, osteosarcoma n 6, MPNST ( malignant peripheral nerve sheath tumor) n = 4, synovial sarcoma n = 3, liposarcoma n = 2, leiomyosarcoma n = 2, rhabdomyosarcoma n = 1, meningosarcoma n = 1). Following chemotherapy and surgery complete remission (CR) ( n = 9), partial remission (PR) ( n = 10), stable disease (SD) (n = 2) and progressive disease (PD) (n = 6) were reached prior HDCT. Different HDCT conditioning regimens were used. One patient died due to cardiac arrest after HDCT. Except hematologic side effects, no WHO grade III - IV complications were observed. Four patients died within 6 months due to PD, disease recurred in another seven patients and led to death, 15 patients are alive with/without disease. The median progression-free survival (PFS) is 12.0 months ( range: 0 - 58), in nine CR patients median PFS is 25.8 months ( range: 3 - 58). Although the role of HDCT in the treatment of sarcomas is not defined, a subgroup of patients who achieved CR before HDCT could benefit from this therapy.