The aim of this study was to identify risk factors associated with PFS in patients with Ewing sarcoma undergoing ASCT; 116 patients underwent ASCT in 1989-2000 and reported to the Center for International Blood and Marrow Transplant Research. Eighty patients (69%) received ASCT as first-line therapy and 36 (31%), for recurrent disease. Risk factors affecting ASCT were analyzed with use of the Cox regression method. Metastatic disease at diagnosis, recurrence prior to ASCT and performance score <90 were associated with higher rates of disease recurrence/progression. Five-year probabilities of PFS in patients with localized and metastatic disease at diagnosis who received ASCT as first-line therapy were 49% (95% CI 30-69) and 34% (95% CI 22-47) respectively. The 5-year probability of PFS in patients with localized disease at diagnosis, and received ASCT after recurrence was 14% (95% CI 3-30). PFS rates after ASCT are comparable to published rates in patients with similar disease characteristics treated with conventional chemotherapy, surgery and irradiation suggesting a limited role for ASCT in these patients. Therefore, ASCT if considered should be for high-risk patients in the setting of carefully controlled clinical trials.
Bibliographical noteFunding Information:
This work was supported by Public Health Service Grant U24-CA76518 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute; Office of Naval Research; Health Services Research Administration (DHHS); and grants from AABB; Abbott Laboratories; Aetna; American International Group Inc.; Amgen Inc.; Anonymous donation to the Medical College of Wisconsin; AnorMED Inc.; Astellas Pharma US Inc.; Baxter International Inc.; Berlex Laboratories Inc.; Biogen IDEC Inc.; BioOne Corporation; Blood Center of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Bristol-Myers Squibb Company; Cangene Corporation; Celgene Corporation; CellGenix GmbH; Cerus Corporation; Cylex Inc.; CytoTherm; DOR BioPharma Inc.; Dynal Biotech, an Invitrogen Company; EKR Therapeutics; Enzon Pharmaceuticals Inc.; Gambro BCT Inc.; Gamida Cell Ltd.; Genzyme Corporation; Gift of Life Bone Marrow Foundation; GlaxoSmithKline Inc.; Histogenetics Inc.; HKS Medical Information Systems; Hospira Inc.; Kiadis Pharma; Kirin Brewery Co., Ltd.; Merck & Company; The Medical College of Wisconsin; Millennium Pharmaceuticals Inc.; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec Inc.; MultiPlan Inc.; National Marrow Donor Program; Nature Publishing Group; Oncology Nursing Society; Osiris Therapeutics Inc.; Pall Life Sciences; PDL BioPharma Inc.; Pfizer Inc.; Pharmion Corporation; Roche Laboratories; Sanofi-aventis; Schering Plough Corporation; StemCyte Inc.; StemSoft Software Inc.; SuperGen Inc.; Sysmex; Teva Pharmaceutical Industries; The Marrow Foundation; THERAKOS Inc.; University of Colorado Cord Blood Bank; ViaCell Inc.; Vidacare Corporation; ViraCor Laboratories; ViroPharma Inc.; Wellpoint Inc.; and Zelos Therapeutics Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, or any other agency of the US Government.