SALVAGE TREATMENT OF RELAPSING WILMS-TUMOR BY AUTOLOGOUS BONE-MARROW TRANSPLANTATION

Despite the remarkable success in treatment of Wilms' tumour there is still a small group who will suffer from relapse. The optimal therapy for relapsing Wilms tumour has not been determined. We have treated fo ur children with high-dose chemotherapy (HDC) followed by stem-cell su pport known as autologous bone marrow transplantation (ABMT). The pati ents were two girls and two boys aged 1-9 years. The histology was fav ourable in 3 cases and unfavourable, clear cell sarcoma, in 1. The rel apses were pulmonary in 2 cases and skeletal in 2 cases. There was no detectable disease prior to ABMT. After ABMT 2 children got further re lapses and died. On the other hand a children had no further relapse a nd are alive and well 1.5-2.5 years later. Treatment with HDC and ABMT is complicated and expensive but may be of benefit and should be adde d to the treatment options in children with otherwise poor prognosis o f Wilms' tumour.