Luo ZY, Fan LQ, Guo WL, Yang JP, Li ZY, Huang YX, Jiang H, Zhang XH. Effect of tandem autologous stem cell transplantation on survival in pediatric patients with high-risk solid tumors in South China. World J Stem Cells 2025; 17(2): 100621 [PMID: 40061267 DOI: 10.4252/wjsc.v17.i2.100621]
Corresponding Author of This Article
Xiao-Hong Zhang, MD, Department of Pediatric Hematology Oncology, Guangdong Women and Children Hospital, No. 318 Renmin Road, Guangzhou 510000, Guangdong Province, China. 2018760286@gzhmu.edu.cn
Research Domain of This Article
Pediatrics
Article-Type of This Article
Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 26, 2025 (publication date) through Feb 26, 2026
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Journal Information of This Article
Publication Name
World Journal of Stem Cells
ISSN
1948-0210
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Luo ZY, Fan LQ, Guo WL, Yang JP, Li ZY, Huang YX, Jiang H, Zhang XH. Effect of tandem autologous stem cell transplantation on survival in pediatric patients with high-risk solid tumors in South China. World J Stem Cells 2025; 17(2): 100621 [PMID: 40061267 DOI: 10.4252/wjsc.v17.i2.100621]
Zi-Yan Luo, Li-Qun Fan, Wen-Ling Guo, Jian-Ping Yang, Zhuo-Yan Li, Yong-Xian Huang, Hua Jiang, Division of Hematology and Oncology, Department of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
Xiao-Hong Zhang, Department of Pediatric Hematology Oncology, Guangdong Women and Children Hospital, Guangzhou 510000, Guangdong Province, China
Co-first authors: Zi-Yan Luo and Li-Qun Fan.
Co-corresponding authors: Hua Jiang and Xiao-Hong Zhang.
Author contributions: Luo ZY and Fan LQ are co-first authors who contributed equally to this work. Luo ZY and Fan LQ both contributed to drafting the initial manuscript; Luo ZY, Fan LQ, Jiang H, and Zhang XH designed and performed the research study; Guo WL, Yang JP, Li ZY, and Huang YX provided help and advice on experiments and analyzed the data. All authors contributed to editorial changes in the manuscript and have read and approved the final manuscript. All authors have contributed significantly to the work and agreed to be accountable for all aspects of the work. Jiang H and Zhang XH as co-corresponding authors, contributed equally to the conceptualization, supervision, and final manuscript revisions, justifying their shared authorship. Jiang H was designed as the primary contact for all journal correspondence.
Supported by Guangzhou Municipal Science and Technology Bureau, Municipal School and College Joint Funding Project, No. 2024A03J1240.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Guangzhou Women and Children’s Medical Center, Guangzhou Medical University (Approval No. 2022-12008).
Informed consent statement: Informed consent was obtained from the legal guardians in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon request.
Corresponding author: Xiao-Hong Zhang, MD, Department of Pediatric Hematology Oncology, Guangdong Women and Children Hospital, No. 318 Renmin Road, Guangzhou 510000, Guangdong Province, China. 2018760286@gzhmu.edu.cn
Received: August 21, 2024 Revised: December 6, 2024 Accepted: February 12, 2025 Published online: February 26, 2025 Processing time: 186 Days and 20.4 Hours
Abstract
BACKGROUND
Despite advances in treatment, the prognosis for patients with high-risk pediatric solid tumors remains dismal. Tandem autologous stem cell transplantation (ASCT) offers promise for improving outcomes in these patients. This study aimed to examine the efficacy and prognostic factors of tandem ASCT in pediatric patients with high-risk solid tumors.
AIM
To determine the survival outcomes and prognostic factors in pediatric patients with high-risk solid tumors undergoing tandem ASCT.
METHODS
A total of 40 pediatric patients with high-risk solid tumors treated from March 2015 to August 2022 were included in this retrospective study. The diagnoses of the patients included neuroblastoma, germ cell tumors, atypical teratoid/rhabdoid tumor, medulloblastoma, and pineoblastoma. After induction chemotherapy, all patients received tandem ASCT and were allocated into two groups (group A and group B) based on high-dose chemotherapy regimens. Prognostic relevance was evaluated by examining patient characteristics, such as sex, age, lactate dehydrogenase levels, primary site, the number of metastatic sites, and bone marrow involvement.
RESULTS
The median follow-up duration since the first ASCT was 24 months (range: 1-91 months), with 5-year overall survival (OS) and event-free survival (EFS) rates of 73% and 70%, respectively, for the entire cohort. The 3-year OS rates were 67% for group A and 87% for group B (P = 0.29), with corresponding 3-year EFS rates of 67% and 79% (P = 0.57). Among neuroblastoma patients, the 5-year OS and EFS were 69% and 63% (P = 0.23). Univariable analysis revealed a notable association of age ≥ 36 months and elevated lactate dehydrogenase level at diagnosis with poorer OS. Despite acute adverse effects, all patients demonstrated good tolerance to the treatment, with no occurrences of transplant-related mortality.
CONCLUSION
Tandem ASCT demonstrates promising survival outcomes for patients with high-risk solid tumors, particularly neuroblastoma, with manageable toxicity and no transplant-related mortality.
Core Tip: This study evaluates the efficacy of tandem autologous stem cell transplantation (ASCT) in improving survival outcomes for pediatric patients with high-risk solid tumors, including neuroblastoma. The results demonstrate that tandem ASCT provides encouraging 5-year overall survival and event-free survival rates, with manageable toxicity and no transplant-related mortality. Key prognostic factors, such as age and lactate dehydrogenase levels at diagnosis, were identified. This study highlights the potential of tandem ASCT as a feasible therapeutic option for high-risk pediatric solid tumors, paving the way for further optimizing treatment strategies.
