Letter to the editor: Uncertain role of high dose chemotherapy with autologous stem cell support in pediatric pleuro-pulmonary blastoma (PPB)
✍ Scribed by Békássy, Albert N.; Garwicz, Stanislaw; Wieve, Thomas; Hägerstrand, Inga
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 17 KB
- Volume
- 28
- Category
- Article
- ISSN
- 0098-1532
No coin nor oath required. For personal study only.
✦ Synopsis
Cell Support in Pediatric Pleuro-Pulmonary Blastoma (PPB)
It is worth mentioning that in their otherwise compre-morphological studies of the tumor appearance ,
which may have some prognostic implications, were hensive review on pleuro-pulmonary blastoma (PPB), Schmaltz et al. [1] made an incorrect and misleading unfortunately not outlined by Schmaltz et al. [1]. Tumors rich in epithelial tubular structures seem to be very statement. Arguing that "so far no attempt of high dose chemotherapy with subsequent bone marrow or blood similar to a hamartoma in appearance and may have good prognosis. Other tumors are highly malignant stem cell transplantation has been published" compels us to draw attention on experience with high dose chemo-leading to death within a year. One can only speculate whether treatment "effectiveness" depends more on therapy [2] published more than a decade ago. We may reiterate that we clearly stated these facts in our previous the biological behavior of the tumor rather than on appropriate chemotherapy. letter to the editor [3] in your journal. Thus, we do believe that the authors' prestigious claim of being first to perform
In order to provide valuable insight to therapy of PPB, there is an important contribution by Dr. Lobo-Sanahuja high dose chemotherapy, should not be accepted without challenge. et al. . They are claiming effective combined chemoand surgical therapy in a 15-year-old girl with PPB. High Our case report [1] concerned a 13-year-old boy who presented with a skull tumor and multiple pulmonary dose chemotherapy remains still promising but merely restricted to patients achieving complete response. Its tumors. He was given three cycles of multidrug chemotherapy according to Rosen's T-11 protocol. The skull hypothetical benefit might be answered by international collaborative study. tumor disappeared after the first cycle of chemotherapy, but the lung masses remained unchanged. The diagnosis of PPB was made on surgically removed specimen from the lung. Uneventful course of Melfalan 140 mg/m 2 was Albert N. Be ´ka ´ssy, MD, MSc Stanislaw Garwicz, MD, PhD then given followed by marrow-derived autologous stem cell support. Local recurrence occurred in the skull and Thomas Wiebe, MD, PhD Division of Pediatric Oncology/Hematology widespread metastases developed later on. The boy succumbed eventually of progressive disease. We concluded Department of Pediatrics Inga Ha ¨gerstrand, MD, PhD that the varying biological behavior of this rare tumor makes the role of combined and high dose chemotherapy Division of Pediatric Oncology/Hematology Department of Clinical Pathology quite uncertain.
We were also surprised by the figures presented by University Hospital S-221 85 Lund, Sweden Schmaltz et al. [1] in their update. Their statement of "not more than 40 cases of true pediatric PPB in the literature published" is unfortunately also incorrect. In 1984, we already quoted 32 children out of about 100 REFERENCES PPB cases. Accumulating simply the cases from the publications cited by the authors themselves [2,4,9,16,17] 1. Schmaltz C, Sauter S, Opitz O, Harms D, Kremens B, Lohner M, in Schmaltz et al. [1] and the cases of papers they were Metz K, Bradis M, Niemeyer C: Pleuro-pulmonary blastoma: A case report and review of the literature. Med Ped Oncol 25:479-not aware of [4,5], one will easily find at least a dozen 484, 1995. more pediatric patients.