High-dose chemotherapy (HDC) following the preservation of autologous stem cells (ASCR) is the only effective treatment for metastatic retinoblastoma, but its applicability in developing countries remains questionable.

Chilean scientists from Hospital Calvo Mackenna, Santiago, report 11 children with this disease (6 of them have unilateral retinoblastoma), who were treated by the HDC-ASCR method in South America. One patient had metastasizing retinoblastoma at the time of diagnosis and remained the only one who experienced a metastatic relapse. A total of 6 metastases in the bone marrow were observed in these patients, 4 in the bone, 5 in the orbit, and 4 in the central nervous system. All patients who received standard chemotherapy achieved remission on average 5. 7 months after the diagnosis of metastasis. The conditioning regimen included carboplatin, etoposide and thiotepu in 6 patients, or with CY in 4 patients or melphalan in one. All patients were then transplanted with ASCR pre-isolated from peripheral blood after mobilization with G-CSF.

There were no deaths due to toxicity of treatment. Two children after ASCR transplant were subjected to radiotherapy of the central nervous system. Seven children achieved a long-term remission, lasting an average of 39 months. Recurrences of metastases in the CNS (n = 3) or systemic (n = 1) occurred on average after 7 months after ASCT transplantation.

During the same period, five children with metastatic retinoblastoma who did not receive HDC-ASCR.

The authors conclude that the high-dose chemotherapy method with autologous stem cell transplantation is effective in treating children with metastatic retinoblastoma and is suitable for use in middle-income countries.

According to Dr. P. Katunyan, the head physician of the Moscow Center for Biomedical Technologies, this method can be successfully applied in Russia.

News. Gradusnik. En.

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