Rapid progression of metastatic osteosarcoma after initiation of a reduced-intensity conditioning regimen with immunosuppressive fludarabine

Pediatr Transplant. 2006 Nov;10(7):822-5. doi: 10.1111/j.1399-3046.2006.00588.x.

Abstract

Indications for RIST have not been established in patients with solid tumors. In this study, we performed RIST as immunotherapy in a 13-yr-old girl with intractable but not progressive osteosarcoma, which originated from the inter-costal region. Carcinomatous pleurisy suddenly developed after the start of a conditioning regimen that included Flu and BUS. She died of respiratory failure on day +19 without signs of engraftment. This case suggests that unexpected acceleration of tumor growth may occur following RIST with immunosuppressive drugs before the development of a beneficial GVT effect.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Bone Neoplasms / diagnosis
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / pathology*
  • Child
  • Disease Progression
  • Fatal Outcome
  • Female
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Magnetic Resonance Imaging
  • Myeloablative Agonists
  • Osteosarcoma / diagnosis
  • Osteosarcoma / drug therapy
  • Osteosarcoma / secondary*
  • Pleural Neoplasms / diagnosis
  • Pleural Neoplasms / secondary*
  • Radiography, Thoracic
  • Vidarabine / adverse effects
  • Vidarabine / analogs & derivatives*
  • Vidarabine / therapeutic use

Substances

  • Antineoplastic Agents
  • Myeloablative Agonists
  • Vidarabine
  • fludarabine