{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:51:03Z","timestamp":1778575863075,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,5,20]],"date-time":"2016-05-20T00:00:00Z","timestamp":1463702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Children's Cancer Group and subsequently Children's Oncology Group (COG)"},{"name":"National Cancer Institute COG Chairman's Grant","award":["U10 CA98543-01 to H.S.N)"],"award-info":[{"award-number":["U10 CA98543-01 to H.S.N)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The outcomes with high\u2010risk central nervous system (CNS) embryonal tumors remain relatively poor despite aggressive treatment. The purposes of this study using postirradiation myeloablative chemotherapy with autologous hematopoietic stem cell rescue (ASCR) were to document feasibility and describe toxicities of the regimen, establish the appropriate dose of thiotepa, and estimate the overall survival (OS) and event\u2010free survival (EFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>The Children's Cancer Group conducted this pilot study in children and adolescents with CNS embryonal tumors. The treatment consisted of induction chemotherapy to mobilize hematopoietic stem cells, chemoradiotherapy, and myeloablative consolidation chemotherapy with ASCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study accrued 25 subjects in 40 months and was closed early due to toxicity, namely, veno\u2010occlusive disease (VOD) of the liver, more recently termed sinusoidal obstructive syndrome (SOS). Of 24 eligible subjects, three of 11 (27%) receiving thiotepa Dose Level 1 (150 mg\/m<jats:sup>2<\/jats:sup>\/day \u00d7 3 days) and three of 12 (25%) receiving de\u2010escalated Dose Level 0 (100 mg\/m<jats:sup>2<\/jats:sup>\/day \u00d7 3 days) experienced VOD\/SOS. One additional subject experienced toxic death attributed to septic shock; postmortem examination revealed clinically undiagnosed VOD\/SOS. The 2\u2010year EFS and OS were 54 \u00b1 10% and 71 \u00b1 9%, respectively. The 5\u2010year EFS and OS were 46 \u00b1 11% and 50 \u00b1 11%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The treatment regimen was deemed to have an unacceptable rate of VOD\/SOS. There was complete recovery in all six cases. The overall therapeutic strategy using a regimen less likely to cause VOD\/SOS may merit further evaluation for the highest risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.26074","type":"journal-article","created":{"date-parts":[[2016,5,22]],"date-time":"2016-05-22T01:07:37Z","timestamp":1463879257000},"page":"1563-1570","source":"Crossref","is-referenced-by-count":17,"title":["High Incidence of Veno\u2010Occlusive Disease With Myeloablative Chemotherapy Following Craniospinal Irradiation in Children With Newly Diagnosed High\u2010Risk CNS Embryonal Tumors: A Report From the Children's Oncology Group (CCG\u201099702)"],"prefix":"10.1002","volume":"63","author":[{"given":"Kellie J.","family":"Nazemi","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology\u2010Oncology Department of Pediatrics Doernbecher Children's Hospital Oregon Health &amp; Science University  Portland Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violet","family":"Shen","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County Cancer Institute  Orange California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan L.","family":"Finlay","sequence":"additional","affiliation":[{"name":"Children's Hospital of Los Angeles Neuro\u2010Oncology Program  Los Angeles California"},{"name":"Division of Hematology, Oncology and BMT Nationwide Children's Hospital  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Boyett","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Saint Jude Children's Research Hospital  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Kocak","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine University of Tennessee Health Science Center  Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Lafond","sequence":"additional","affiliation":[{"name":"Department of Hematology\u2010Oncology Children's National Health System  Washington District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon L.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Hassenfeld Children's Center, Langone Medical Center New York University  New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger J.","family":"Packer","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Behavioral Medicine Brain Tumor Institute  Washington District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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