Table 85Overall survival for single auto HSCT and comparison (conventional chemotherapy +/- radiation) groups: Glial tumors

IndicationOutcomeIntervention Single (%; ± 95% CI)Comparator Chemo (%; ± 95% CI)P ValueStudy
Astrocytoma1 year∼41 (N=10)∼26 (N=29)Chemo vs. ABMR unstratified comparison of survival p=.0018 HR 1.9 (1.1-3.1)
Chemo versus ABMR comparison stratified by histology: p=.010
Chemo/nonbulky versus ABMR/non-bulky unstratified exact comparison:
p=0.017 [hazard ratio=9.1 (95% confidence interval 1.7–47.2)
Minimal residual disease status (<3 cm tumor diameter) at time of myeloablative chemotherapy p=.003
Finlay, 2008485
Not applicable2 AA patients dead at median 7.1 mo (n=2)Not reportedShih, 2008132
Not applicable3 AA dead at median 5mo (4-10mo) (n=3)Not reportedDe Sio, 2006509
Not applicable1 patient DOD at 4 mo (50%), one patient alive with disease progression at 10+ months (n=2)Not reportedKorones, 2006518
Not applicable∼46 (n=30)Not reportedMacdonald, 2005521
Other Glioma ∼91 (Anaplastic astrocytoma (N=9) and anaplastic oligodendroglioma (N=2)) (N=11)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse p=.004Massimino, 2005502
Not applicable∼83 GBM and AA Non-Infants (n=16)
∼52 GBM and AA Infants (n=6)
Not reportedBertolone, 2003491
Not applicable28±10% (n=35)Not reportedKobrinsky, 1999517
2 AA patients dead at 7 and 9 mo (N=2)Not applicableNot reportedJakacki, 1999500
3 Year40±14%
(N=10)
7±4%
(N=29)
Chemo vs. ABMR unstratified comparison of survival p=.0018 HR 1.9 (1.1-3.1)
Chemo versus ABMR comparison stratified by histology: p=.010
Chemo/nonbulky versus ABMR/non-bulky unstratified exact comparison:
p=0.017 [hazard ratio=9.1 (95% confidence interval 1.7–47.2)
Minimal residual disease status (<3 cm tumor diameter) at time of myeloablative chemotherapy p=.003
Finlay, 2008485
Not applicable∼25 (N=30)Not reportedMacdonald, 2005521
Other Glioma ∼73 (Anaplastic astrocytoma (N=9) and anaplastic oligodendroglioma (N=2)) (N=11)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse P=.004Massimino, 2005502
Not applicable∼57 GBM and AA Non-Infants (N=16)
∼25 GBM and AA Infants (N=6)
Not reportedBertolone, 2003491
Not applicable∼5 (N=35)Not reportedKobrinsky, 1999517
Not applicable3 OA patients alive median 3 yr.Not reportedDoireau, 1999510
1 patient died at 15 mo (N=1)Not applicableNot reportedBusca, 1997495
5 Year40±14% (N=10)0-4% (N=29)Chemo vs. ABMR unstratified comparison of survival p=.0018 HR 1.9 (1.1-3.1)
Chemo versus ABMR comparison stratified by histology: p=.010
Chemo/nonbulky vs. ABMR/non-bulky unstratified exact comparison:
p=0.017 [hazard ratio=9.1 (95% confidence interval 1.7–47.2)
Minimal residual disease status (<3 cm tumor diameter) at time of myeloablative chemotherapy P=.003
Finlay, 2008485
Not applicable25±8% (N=30)Not reportedMacdonald, 2005521
Other glioma ∼73 (Anaplastic astrocytoma (N=9) and AOA (N=2)) (N=11)Not applicableOS for GBM compared to other histotypes (AA and ODG) were worse p=.004Massimino, 2005502
2 Anaplastic astrocytoma pts. alive with stable disease at follow up of 41 and 80 mo (N=2)Not applicableNot reportedOzkaynak, 2004367
Not applicable36±13 GBM and AA Non-Infants (N=11)
25±15 GBM and AA Infants (N=6)
Not reportedBertolone, 2003491
Not applicable0% (N=35)Not reportedKobrinsky, 1999517
Not applicable1 AA patient died (car accident) before last FU.
1 AOA patient alive at 5.5 year.
1 Astrocytoma patient with unspecified disease alive at 5.5 years (N=6)
Not reportedDoireau, 1999510
2 AA patients died at 1 mo and 4 mo (N=2)Not applicableNot reportedMahoney, 1996501
50 (N=2)
1 AA patient alive with residual disease at 7.7 years
1 oligoastrocytoma patient DOT at 1 mo
Not applicableNot reportedGilheeney, 2010492
Glioblastoma multiforme1 Year∼43% (N=17)∼22% (N=27)Chemo vs. ABMR unstratified comparison of survival p=.0018 HR 1.9 (1.1-3.1)
Chemo versus ABMR comparison stratified by histology: p=.010
Chemo/nonbulky versus ABMR/non-bulky unstratified exact comparison:
p=0.017 [hazard ratio=9.1 (95% confidence interval 1.7–47.2)
Minimal residual disease status (<3 cm tumor diameter) at time of myeloablative chemotherapy p=.003
Finlay, 2008485
Not applicable1 patient dead at 4 mo (N=2)Not reportedShih, 2008132
Not applicable1 patient AWD at 12 mo (N=1)Not reportedDe Sio, 2006509
Not applicable57% (n=7)Not reportedKorones, 2006518
Not applicable∼45 (N=40)Not reportedMacdonald, 2005521
∼90% (N=10)Not applicableOS for GBM compared to other histotypes (AA and ODG) were worse p=.004Massimino, 2005502
1 progressive patient DOD at 1 mo (N=1)Not applicableNot reportedOzkaynak, 2004367
Not applicable∼83 GBM and AA Non-Infants (N=16)
∼52 GBM and AA Infants (N=6)
Not reportedBertolone, 2003491
73±13% (N=11)Not applicableNot reportedGrovas, 1999498
1 patient DOD at 6 months, 1 patient had stable disease at last 12 mo FU, 1 patient died of treatment toxicity (N=3)Not applicableNot reportedYule, 1997504
1 patient dead of disease at 7 mo (N=1)Not applicableNot reportedMahoney, 1996501
2 GBM patients DOD at 6 mo and 10 mo (N=2)Not applicableNot reportedGilheeney, 2010492
3 Year12±6% (N=17)0% (N=27)Chemo vs. ABMR unstratified comparison of survival p=.0018 HR 1.9 (1.1-3.1)
Chemo versus ABMR comparison stratified by histology: p=.010
Chemo/nonbulky versus ABMR/non-bulky unstratified exact comparison:
p=0.017 [hazard ratio=9.1 (95% confidence interval 1.7–47.2)
Minimal residual disease status (<3 cm tumor diameter) at time of myeloablative chemotherapy p=.003
Finlay, 2008485
Not applicable∼25%(N=40)Not reportedMacdonald, 2005521
∼30% (N=10)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse p=.004Massimino, 2005502
Not applicable∼57 GBM and AA Non-Infants (N=16)
∼25 GBM and AA Infants (N=6)
Not reportedBertolone, 2003491
∼35% (N=11)Not applicableNot reportedGrovas, 1999498
3 pts DOD at median 15 mo (6 – 19 mo) (N=3)Not applicableNot reportedJakacki, 1999500
1 pt alive and progression free at final FU (N=1)Not applicableNot reportedBusca, 1997495
5 Year12±6% (N=17)0% (N=27)Chemo vs. ABMR unstratified comparison of survival p=.0018 HR 1.9 (1.1-3.1)
Chemo versus ABMR comparison stratified by histology: p=.010
Chemo/nonbulky versus ABMR/non-bulky unstratified exact comparison:
p=0.017 [hazard ratio=9.1 (95% confidence interval 1.7–47.2)
Minimal residual disease status (<3 cm tumor diameter) at time of myeloablative chemotherapy p=.003
Finlay, 2008485
Not applicable1 patients dead at 104 mo (N=2)Not reportedShih, 2008132
Not applicable22±7 (N=40)Not reportedMacdonald, 2005521
0% (N=10)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse p=.004Massimino, 2005502
Not applicable36±13 GBM and AA Non-Infants (N=16)
25±15 GBM and AA Infants (N=6)
Not reportedBertolone, 2003491
∼25 (N=11)Not applicableNot reportedGrovas, 1999498
Anaplastic ependymoma1 YearNot applicable100% (N=12)Not reportedRobertson, 1998489
1 anaplastic ependymoma patient with tandem autologous treatment DOD at 15 mo (N=1)Not applicableNot reportedYule, 1997504
3 YearNot applicable82% (59-100%) (N=12)Not reportedRobertson, 1998489
Not applicableMedian 33 months (16-35mo) (N=4)Not reportedAyan, 1995507
5 YearNot applicable35.2±11.0% (N=23)Not reportedJaing, 2004516
Not applicable64% (25-84%) (N=12)Not reportedRobertson, 1998489
Non-anaplastic, mixed, or unspecified ependymoma1 YearNot applicable3 patients dead at 1.4, 2.4, and 3.6 mo (N=3)Not reportedShih, 2008132
Not applicableMetastatic ∼89% (N=9)
Non-Metastatic ∼95% (N=80)
Age< 1 year, p=.18
Female sex, p=.18
Infratentorial, p=.12
WHO gr. III, p=.15
Partial resection (judged by neurosurgeon) p=.07
Partial resection (radiologic review) p=.28
Dose intensity <.8, p=.05 HR=1.6 (1.0-2.7)
Grundy, 2007512
∼80% (N=29)Not applicableGTR vs. <GTR not significantZacharoulis, 2007490
Not applicableDOD at 2 and 6 mo (N=2)Not reportedDe Sio, 2006509
Not applicable∼96% (N=73)PF tumor RR 7.9 (1.8 to 35) p=.0004

Postoperative radiologic documented residuum: RR 3.6 (1.7-7.7) p=.0009
Grill, 2001511
Not applicable95% (85-100%) (N=20)Not reportedRobertson, 1998489
75 (54-96 95% CI) (N=16)Not applicableNot reportedGrill, 1996497
2 patients dead at 7 and 9 months (67%) and one patient alive with progression at 25+ months (N=3)Not applicableNot reportedMahoney, 1996501
3 Year79% (63.9-95.4) (N=23)Complete vs. partial resection not significantConter, 2009508
Not applicableMetastatic ∼58% (N=9)
Non-Metastatic ∼80% (N=80)
Age< 1 year, p=.18
Female sex, p=.18
Infratentorial, p=.12
WHO gr. III, p=.15
Partial resection (judged by neurosurgeon) p=.07
Partial resection (radiologic review) p=.28
Dose intensity <.8, p=.05 HR=1.6 (1.0-2.7)
Grundy, 2007512
∼62% (N=29)Not applicableGTR vs. <GTR not significantZacharoulis, 2007490
Not applicable∼68% (N=73)PF tumor RR 7.9 (1.8 to 35) p=.0004

Postoperative radiologic documented residuum: RR 3.6 (1.7-7.7) p=.0009
Grill, 2001511
Not applicable65 (44-86%) (N=20)Not reportedRobertson, 1998489
31 (3-58 95% CI) (N=16)Not applicableNot reportedGrill, 1996497
5 YearNot applicable74% (57.3-92.3) (N=23)Complete vs. partial resection NSConter, 2009508
Not applicableMetastatic ∼28% (N=80)
Nonmetastatic ∼ 63 (N=9)
Age< 1 year, p=.18
Female sex, p=.18
Infratentorial, p=.12
WHO gr. III, p=.15
Partial resection (neurosurgeon) p=.07
Partial resection (radiologic review) p=.28
Dose intensity <.8, p=.05 HR=1.6 (1.0-2.7)
Grundy, 2007512
38±10 (N=29)Not applicableGTR vs. <GTR NSZacharoulis, 2007490
2 patients alive NED at last FU 20 mo, 67 mo (N=2)Not applicableNot reportedBusca, 1997495
10 (0-29 95% CI) (N=16)Not applicableNot reportedGrill, 1996497
Not applicable52±(38 to 65%) (N=73)PF tumor RR 7.9 (1.8 to 35) p=.0004
Postoperative radiologic documented residuum: RR 3.6 (1.7-7.7) p=.0009
Grill, 2001511
Not applicableGrade II 73.7±10.2% (N=20)
Complete resection (N=18): 82.1±9.5%
Incomplete resection (N=19): 36.8±11.8%
Biopsy (N=6): 33.3±19.3%
Age <3 years (N=9): 41.7±17.3%
Age >3 years (N=34): 57.4±9.1%
Anaplasia p<.001
Surgical Resection p<.001
Age p=.036
Jaing, 2004516
1 patient alive with stable disease at 62 months (N=1)Not applicableNot reportedOzkaynak, 2004367
Not applicable57.2±5 (N=83)Age (<=3yr at diagnosis vs. >3 yr) p=.005; HR .04 (.2-.8)
Deg. resection (GTR vs. <GTR) p=.01; HR 2.4(1.2-4.9)
Histology (grade II vs. III) p=.05; HR 1.9 (.99-3.4)
Horn, 1999514
Not applicable6 pts DOD at 4.5 mo (N=21)Not reportedKuhl, 1998520
Not applicable53% (31-76%) (N=20)Not reportedRobertson, 1998489
Not applicable50.3 (23.1-72.4) (N=15)Not reportedGrundy, 2010513
Choroid plexus carcinoma (CPC)1 YearNot applicable∼82 (N=29)Tumor Type (Choroid plexus carcinoma vs. choroid plexus paplioma and atypicalb choroid plexus paplioma) HR 26.4 p=.003Wrede, 2009522
2 partially resected pts DOD at 21 and 25 mo (N=2)13 patients DOD at median time 9 mo (range 4-41 mo) (65%)
7 patients Alive and well at median follow up 25 mo (range 3-85 mo) (35%)

1 of 8 gross total resection patients died (12.5%)
11 of 12 partial resection patients died (92%) (N=20)
Not reportedBerger, 1998488
1 patient DOD at 5 months (N=1)Not applicableNot reportedGururangan, 1998499
1 pt dead at 11 mo (N=1)Not applicableNot reportedYule, 1997504
Not applicable50.3 (23.1-72.4) (N=15)Not reportedGrundy, 2010513
3 YearNot applicable∼70 (N=29)Tumor Type (Choroid plexus carcinoma vs. choroid plexus paplioma and atypical choroid plexus paplioma) HR 26.4 p=.003Wrede, 2009522
Not applicable21.5 (5.2-45.0)
3(N=15)
Not reportedGrundy, 2010513
5 YearNot applicable36 (9-100) (N=29)Tumor Type (Choroid plexus carcinoma vs. choroid plexus paplioma and atypical choroid plexus paplioma) HR 26.4 p=.003Wrede, 2009522
Not applicable21.5 (5.2-45.6) (N=15)Not reportedGrundy, 2010513
Other glioma1 Year1 Oligodendroglioma dead at 8 mo (N=1)Not applicableNot reportedThorarinsdottir, 2007503
Not applicableMedian BSG OS 9mo (3-11) (33%) (N=8)Not reportedDe Sio, 2006509
Not applicable2 patients w/brainstem glioma DOD at 4 and 8 mo (N=2)Not reportedKorones, 2006518
Other glioma ∼91 (Anaplastic astrocytoma (N=9) and anaplastic oligodendroglioma (N=2)) (N=11)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse P=.004Massimino, 2005502
Not applicableOther Glioma ∼62 (N=6)Not reportedMacdonald, 2005521
2 recurrent BSG patient DOD at 4 and 9 mo (N=2)Not applicableNot reportedOzkaynak, 2004367
Pontine ∼25 (N=24)Not applicableNot reportedBouffet, 1997493
Not applicableBrainstem Glioma 9±5 (N=22)Not reportedKobrinsky, 1999517
1 Pons patient alive at last follow up. 5 patients DOD at median 8 mo (5-14 mo) (N=6)Not applicableNot reportedJakacki, 1999500
Median survival of pontine glioma patients was 4 mo (N=10)Not applicableNot reportedDunkel, 1998496
Median survival of HGG patients was 3 mo (12d-11 mo) (N=13)Not applicableNot reportedBouffet, 1997493
1 oligodendroglioma dead at 10 mo (N=1)Not applicableNot reportedBusca, 1997495
Not applicable1 BSG dead at 2 mo (N=1)Not reportedMahoney, 1996501
Not applicableHGG 57.9 (33.2-76.3) (N=19)Not reportedGrundy, 2010513
3 YearOther glioma ∼73 (Anaplastic astrocytoma (N=9) and anaplastic oligodendroglioma (N=2)) (N=11)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse p=.004Massimino, 2005502
Not applicable3 year OS: Other glioma ∼62 (N=6)Not reportedMacdonald, 2005521
Pontine ∼0. (N=24)Not applicableNot reportedBouffet, 1997493
Not applicableBrainstem glioma 0 (N=22)Not reportedKobrinsky, 1999517
Not applicableHGG 40.5 (18.7-61.5) (N=19)Not reportedGrundy, 2010513
5 Year1 ganglioma patient dead at 59 mo (N=1)Not applicableNot reportedThorarinsdottir, 2007503
Other glioma ∼73 (Anaplastic astrocytoma (N=9) and anaplastic oligodendroglioma (N=2)) (N=11)Not applicableOS for glioblastoma multiforme compared to other histotypes (AA and ODG) were significantly worse p=.004Massimino, 2005502
Not applicableOther glioma ∼38 (N=6)Not reportedMacdonald, 2005521
Not applicableMalignant glioma 36 ± 10 (N=22)Not reportedKuhl, 1998520
Not applicableHGG 34.7 (14.6-56.0) (N=19)Not reportedGrundy, 2010513
Astrocytoma (summary comparison)OS Range for 5 years for studies with ≥10 patientsNewly Diagnosed:
∼73%*
(Massimo, 2005 502)
[*This study included 9 Anaplastic Astrocytoma patients and 2 lower-grade oligodendroglioma patients.]
Massimo measured from time of diagnosis
Newly Diagnosed:
25%
(Macdonald 521N=30)
Macdonald measured from time of study entry to death
Not applicableBertolone 491 was not included in this estimate because the study did not differentiate between AA and GBM patients
Recurrent/Pro gressive:
40%
(Finlay 485 N=17)
Measured from time of myeloablative chemotherapy
Recurrent/Progressive:
0%
(Finlay 485 N=27)
Measured from time of recurrence
Not applicableBertolone 491 was not included in this estimate because the study did not differentiate between AA and GBM patients
Glioblastoma multiforme (summary comparison)5 year OS for all studies with N ≥10 patientsNewly Diagnosed:
0-22%
(Grovas 498 N=11, Massimo 502 N=10)
Grovas measured from time of stem cell rescue Massimo considered OS from date of chemotherapy
Newly Diagnosed:
22%
(Macdonald 521 N=40)
Macdonald measured from time of study entry to death
Not applicableBertolone 491 was not included in this estimate because the study did not differentiate between AA and GBM patients
Recurrent/Progressive:
12%
(Finlay 485 N=17)
Measured from time of myeloablative chemotherapy
Recurrent/Progressive:
0%
(Finlay 485 N=27)
Measured from time of recurrence
Not applicableBertolone 491 was not included in this estimate because the study did not differentiate between AA and GBM patients
Ependymoma (summary comparison)5 year OS for studies with N ≥10 patientsNewly Diagnosed, unspecified anaplastic
38%
(Zacharoulis 490 N=29)
Zacharoulis estimated OS from date of diagnosis
Newly Diagnosed Nonanaplastic, mixed, or unspecified Ependymoma:
52-74%
(Conter 508 N=23, Grill, 2001 511 N=14, Horn 514 N=83, Jaing 516 N=20, Robertson489 N=20)
Conter and Jaing estimated OS from date of surgery, Grill measured from date of chemotherapy, Robertson measured from date of randomization, and Horn measured from date of diagnosis. Overall, these differing estimates of overall survival approximate date of surgery within 13 weeks.
Newly Diagnosed Anaplastic Ependymoma:
35.2-64%
(Jaing 516 N=23 and Robertson 489 N=12)
Jaing used date of surgery for OS calculation and Robertson used date of randomization
Not applicableGrundy et al. was not included in this estimate because the study stratified by metastasis finding a 5 year OS of 28% for metastatic ependymoma and 63% for nonmetastatic disease and measured the OS from date of surgery.
Ependymoma (summary comparison)5 year OS for studies with N ≥10 patientsNo patients alive past 25 months.
(Berger 488 N=2, Gururangan 499 N=1, Yule 504 N=1)
21.5-36%
(Grundy N=15 and Wrede 522 N=29)
Wrede measured OS from date of diagnosis and Grundy used date of surgery
Not applicableNot applicable
Choroid plexus carcinoma (summary comparison)5 Year OS All studiesNo patients alive past 25 months.
(Berger 488 N=2, Gururangan 499 N=1, Yule 504 N=1)
21.5-36%
(Grundy N=15 and Wrede 522 N=29)
Wrede measured OS from date of diagnosis and Grundy used date of surgery
Not applicableNot applicable

From: Systematic Reviews

Cover of Hematopoietic Stem-Cell Transplantation in the Pediatric Population
Hematopoietic Stem-Cell Transplantation in the Pediatric Population [Internet].
Comparative Effectiveness Reviews, No. 48.
Ratko TA, Belinson SE, Brown HM, et al.

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