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TREATMENT PLAN FOR HIGH RISK NEUROBLASTOMA
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Treatment Plan for High Risk Neuroblastoma
REGISTRATION: CHILD IS RANDOMIZED TO HAVE A PURGED OR UNPURGED STEM CELL TRANSPLANT (TAYLOR SELECTED AS UNPURGED) COMPLETEDINDUCTION CHEMOTHERAPY:
  1. CYCLE 1 OF INDUCTION: COMPLETED
    CYCLOPHOSPHAMIDE: 6 HOURS A DAY FOR 2 DAYS
    MESNA: 6 HOURS + ADDITIONAL 15 MINUTE DOSES A DAY FOR 2 DAYS
    DOXORUBICIN: 72 CONTINUOUS HOURS
    VINCRISTINE: 72 CONTINUOUS HOURS
  2. CYCLE 2 OF INDUCTION: COMPLETED
    CYCLOPHOSPHAMIDE: 6 HOURS A DAY FOR 2 DAYS
    MESNA: 6 HOURS + ADDITIONAL 15 MINUTE DOSES A DAY FOR 2 DAYS
    DOXORUBICIN: 72 CONTINUOUS HOURS
    VINCRISTINE: 72 CONTINUOUS HOURS
    ----STEM CELL COLLECTION: COMPLETED----
  3. CYCLE 3 OF INDUCTION: COMPLETED
    CISPLATIN 1 HOUR A DAY FOR 4 DAYS
    ETOPOSIDE 2 HOURS A DAY FOR 3 DAYS
    ----SECOND STEM CELL COLLECTION (COMPLETED, AND CANCER FREE!!! (HIS STEM CELLS, NOT HIS BODY))----
  4. CYCLE 4 OF INDUCTION: COMPLETED
    CYCLOPHOSPHAMIDE: 6 HOURS A DAY FOR 2 DAYS
    MESNA: 6 HOURS + ADDITIONAL 15 MINUTE DOSES A DAY FOR 2 DAYS
    DOXORUBICIN: 72 CONTINUOUS HOURS
    VINCRISTINE: 72 CONTINUOUS HOURS
  5. CYCLE 5 OF INDUCTION: COMPLETED
    CISPLATIN 1 HOUR A DAY FOR 4 DAYS
    ETOPOSIDE 2 HOURS A DAY FOR 3 DAYS
    ----SURGERY (NOT NECESSARY REMOVED ENTIRE TUMOR ON 10-15-2002)----
  6. CYCLE 6 OF INDUCTION: COMPLETED!!!!
    CYCLOPHOSPHAMIDE: 6 HOURS A DAY FOR 2 DAYS
    MESNA: 6 HOURS + ADDITIONAL 15 MINUTE DOSES A DAY FOR 2 DAYS
    DOXORUBICIN: 72 CONTINUOUS HOURS
    VINCRISTINE: 72 CONTINUOUS HOURS
Tests to be done prior to Stem Cell Transplant: (Schedule could Change) March 10, 2002: 8:00 AM-CT Scan, 12:00PM Bone Scan COMPLETEDMarch 11, 2002:8:00AM Dental Examination, 1:00PM MIGB Scan COMPLETEDMarch 12, 2002: 8:00AM-11:00AM Bone Marrow Biopsy COMPLETED/CLEAN CANCER FREE!!!March 13, 2002: 24 HR Urine/Kidney Test COMPLETEDMarch 17, 2002: Results from all Tests, final consultation with Dr. Berkow, Final Evaluation from Stem Cell COMPLETEDTAYLOR IS ELIGIBLE FOR STEM CELL TRANSPLANT, AND HE WILL FOLLOW PROCEDURES ON LEFT.
PATIENTS ELIGIBLE FOR STEM CELL TRANSPLANT: (4 steps)
1. CONSOLIDATION CHEMOTHERAPY (1 CYCLE)
    CARBOPLATIN 96 CONTINUOUS HOURS
    ETOPOSIDE 96 CONTINUOUS HOURS
    MELPHALAN 3 DAYS
2. STEM CELL TRANSPLANT WITH PURGED    STEM CELLS3. RADIATION THERAPY4. POSSIBLE ENTRY INTO 2ND TRIAL: (TO BE      DETERMINED) RANDOMIZED EITHER:
    USING 13-CIS RETINOIC ACID THERAPY (6     CYCLES) ONLY                      OR     ANTIBODIES COMBINED WITH 13-CIS     RETINIOIC ACID THERAPY (6 CYCLES)
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PATIENTS INELIGIBLE FOR STEM CELL TRANSPLANT: (2 steps)
1. MAINTENANCE CHEMOTHERAPY (3 CYCLES):

    CYCLE 1:
    TOPOTECAN 30 MINUTES A DAY FOR 5 DAYS
    CYCLOPHOSPHAMIDE 30 MINUTES A DAY FOR 5
    DAYS
    MESNA BEFORE CYCLOPHOSPHAMIDE AND 3
    HRS LATER     CYCLE 2:
    TOPOTECAN 30 MINUTES A DAY FOR 5 DAYS
    CYCLOPHOSPHAMIDE 30 MINUTES A DAY FOR 5     DAYS
    MESNA BEFORE CYCLOPHOSPHAMIDE AND 3     HRS LATER     CYCLE 3:
    TOPOTECAN 30 MINUTES A DAY FOR 5 DAYS
    CYCLOPHOSPHAMIDE 30 MINUTES A DAY FOR 5     DAYS
    MESNA BEFORE CYCLOPHOSPHAMIDE AND 3     HRS LATER 2. 13-CIS RETINOIC ACID THERAPY (6 CYCLES)