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Peripheral Blood Stem Cell Tumor Cell Contamination and Survival of Neuroblastoma Patients

Authors' Affiliations: ¹ Laboratory of Oncology; ² Epidemiology and Biostatistics Section, Scientific Directorate; ³ Service of Immunohematology and Transfusional Medicine; and ⁴ Department of Hematology-Oncology, Gaslini Institute, Genoa, Italy

Requests for reprints: Maria Valeria Corrias, Laboratory of Oncology, Gaslini Institute, L.go Gaslini, 5 16147 Genoa, Italy. Phone: 39-010-5636-342; Fax: 39-010-3779820; E-mail: mariavaleriacorrias{at}ospedale-gaslini.ge.it

Purpose: Contribution of peripheral blood stem cell (PBSC) contaminating tumor cells to subsequent relapse and overall survival of neuroblastoma patients remains controversial.

Experimental Design: Neuroblastoma cell contamination of 27 PBSC harvests from stage IV neuroblastoma patients was assessed by quantitative RT-PCR for both tyrosine hydroxylase (TH) and GD2 synthase (GD2-s). The effect of PBSC contamination on survival was then analyzed.

Results: Seven PBSC tested negative for both markers; 19 were positive for GD2-s, 6 for TH, with 5 positive for both. Survival of the 20 patients with positive PBSC did not differ from that of the patients with negative PBSC (log-rank test, P = 0.134 and 0.218 for event-free survival and overall survival, respectively). By considering the TH and GD2-s results independently, a borderline (P = 0.053) negative effect on event-free survival was observed in patients reinfused with GD2-s-positive PBSC. When the status at transplant was taken into account, only the event-free survival of the patients rescued when in complete remission with GD2-s-negative PBSC was better, although not significantly, than that of patients infused with GD2-s-positive PBSC.

Conclusions: Our results obtained in a small cohort of homogeneously treated stage IV patients suggest that patient survival is not affected by PBSC contamination with the exception of a borderline negative effect on event-free survival in patients rescued when in complete remission.

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