Medulloblastoma is treated primarily with surgical excision followed by radiation therapy and chemotherapy. When there is spinal extension, craniospinal radiation is standard.
Inoperable medulloblastomas are often treated iwth chemotherapy but there is no randomized prospective evidence to support this. This is especially so in adults, in whom this disease is much less common and in whom it appears to behave distinctly differently. 30% of cases occur in adults.
Autologous transplantation of relapsed disease ahs support from case reports, series and small prospective trials. There are but a few case reports of allogeneic transplantation for medulloblastoma, some of them from the older literature. I am not aware of any cases of allogeneic being used after failure of autologous stem cell transpalntation that have been reported.
David D Eisenstat Clinical management of medulloblastoma in adults
Expert Review of Anticancer Therapy October 2004, Vol. 4, No. 5, Pages 795-802
S Secondino Antitumor effect of allogeneic hematopoietic SCT in metastatic medulloblastoma
Bone Marrow Transplantation (2008) 42, 131–133;
Lundberg JH, Weissman DE, Beatty PA, Ash RC. Treatment of recurrent metastatic medulloblastoma with intensive chemotherapy and allogeneic bone marrow transplantation. J Neurooncol 1992; 13: 151–155.
Matsuda Y, Hara J, Osugi Y, Fujisaki H, Takai K, Ohta H et al. Allogeneic peripheral stem cell transplantation using positively selected CD34+ cells from HLA-mismatched donors. Bone Marrow Transplant 1998; 21: 355–360. J Korean Med Sci. 2010 Aug;25(8):1160-1166.
Jun Eun Park et al, Efficacy of High-dose Chemotherapy and Autologous Stem Cell Transplantation in Patients with Relapsed Medulloblastoma: A Report on The Korean Society for Pediatric Neuro-Oncology (KSPNO)-S-053 Study
Korean Med Sci. 2010 Aug;25(8):1160-1166.
Comments