Mosse, Yael P., Deyell, Rebecca J., Berthold, Frank, Nagakawara, Akira, Ambros, Peter F., Monclair, Tom, Cohn, Susan L., Pearson, Andrew D., London, Wendy B. and Matthay, Katherine K. (2014). Neuroblastoma in Older Children, Adolescents and Young Adults: A Report From the International Neuroblastoma Risk Group Project. Pediatr. Blood Cancer, 61 (4). S. 627 - 636. HOBOKEN: WILEY-BLACKWELL. ISSN 1545-5017

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Abstract

BackgroundNeuroblastoma in older children and adolescents has a distinctive, indolent phenotype, but little is known about the clinical and biological characteristics that distinguish this rare subgroup. Our goal was to determine if an optimal age cut-off exists that defines indolent disease and if accepted prognostic factors and treatment approaches are applicable to older children. ProcedureUsing data from the International Neuroblastoma Risk Group, among patients 18 months old (n=4,027), monthly age cut-offs were tested to determine the effect of age on survival. The prognostic effect of baseline characteristics and autologous hematopoietic cell transplant (AHCT) for advanced disease was assessed within two age cohorts; 5 to <10 years (n=730) and 10 years (n=200). ResultsOlder age was prognostic of poor survival, with outcome gradually worsening with increasing age at diagnosis, without statistical evidence for an optimal age cut-off beyond 18 months. Among patients 5 years, factors significantly prognostic of lower event-free survival (EFS) and overall survival (OS) in multivariable analyses were INSS stage 4, MYCN amplification and unfavorable INPC histology classification. Among stage 4 patients, AHCT provided a significant EFS and OS benefit. Following relapse, patients in both older cohorts had prolonged OS compared to those 18 months to <5 years (P<0.0001). ConclusionsDespite indolent disease and infrequent MYCN amplification, older children with advanced disease have poor survival, without evidence for a specific age cut-off. Our data suggest that AHCT may provide a survival benefit in older children with advanced disease. Novel therapeutic approaches are required to more effectively treat these patients. Pediatr Blood Cancer 2014;61:627-635. (c) 2013 Wiley Periodicals, Inc.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Mosse, Yael P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deyell, Rebecca J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berthold, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nagakawara, AkiraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ambros, Peter F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monclair, TomUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cohn, Susan L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pearson, Andrew D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
London, Wendy B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matthay, Katherine K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-442821
DOI: 10.1002/pbc.24777
Journal or Publication Title: Pediatr. Blood Cancer
Volume: 61
Number: 4
Page Range: S. 627 - 636
Date: 2014
Publisher: WILEY-BLACKWELL
Place of Publication: HOBOKEN
ISSN: 1545-5017
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INDOLENT COURSE; ONCOLOGY-GROUP; N-MYC; AGE; AMPLIFICATION; EXPERIENCE; DIAGNOSIS; SURVIVAL; CLASSIFICATION; CHEMOTHERAPYMultiple languages
Oncology; Hematology; PediatricsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44282

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