High-dose chemotherapy with hematopoietic stem cell transplantation in adults with bone marrow relapse of medulloblastoma: report of two cases

Extraneural relapses of medulloblastoma are associated with a very poor out come. We present two cases of young adults who developed bone marrow metast ases after treatment of medulloblastoma, A very good response to a sequenti ally scheduled combination of carboplatin and etoposide was observed. Then, high-dose chemotherapy was delivered consisting of busulfan and thiotepa f ollowed by infusion of autologous hematopoietic stem cells. Toxicity of the conditioning regimen was acceptable. The patients remained free of disease 20 and 27 months from the time of relapse, respectively. Further studies a re needed to evaluate the impact of high-dose chemotherapy in terms of surv ival of such patients.