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Impact of Diagnostic and End-Induction Curie Scores with Tandem Autologous Transplants for Metastatic High-Risk Neuroblastoma: A Report from the Children’s Oncology Group
  • +11
  • Keri Streby,
  • Meg Parisi,
  • Barry Shulkin,
  • Brian LaBarre,
  • Rochelle Bagatell,
  • Lisa Diller,
  • Stephan A. Grupp,
  • Katherine Matthay,
  • Stephan Voss,
  • Alice Lin Tsing Yu,
  • Wendy London,
  • Julie Park,
  • Gregory Yanik,
  • Arlene Naranjo
Keri Streby
Nationwide Children's Hospital Hematology Oncology & Blood and Marrow Transplant

Corresponding Author:keri.streby@nationwidechildrens.org

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Meg Parisi
University of Washington Department of Radiology
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Barry Shulkin
St Jude Children's Research Hospital
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Brian LaBarre
University of Florida Department of Biostatistics
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Rochelle Bagatell
The Children's Hospital of Philadelphia
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Lisa Diller
Dana-Farber/Boston Children's Cancer and Blood Disorders Center
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Stephan A. Grupp
The Children's Hospital of Philadelphia
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Katherine Matthay
University of California San Francisco Department of Pediatrics
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Stephan Voss
Boston Children's Hospital
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Alice Lin Tsing Yu
University of California San Diego
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Wendy London
Dana-Farber/Boston Children's Cancer and Blood Disorders Center
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Julie Park
University of Washington Department of Pediatrics
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Gregory Yanik
University of Michigan Department of Pediatrics
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Arlene Naranjo
University of Florida Department of Biostatistics
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Abstract

BACKGROUND: Diagnostic mIBG (meta-iodobenzylguanidine) scans are an integral component of response assessment in children with high-risk neuroblastoma. The role of end of induction (EOI) Curie Scores (CS) was previously described in patients undergoing a single autologous hematopoietic cell transplant (AHCT) as consolidation therapy. OBJECTIVE: We now examine the prognostic significance of CS in patients randomized to tandem AHCT on the Children’s Oncology Group (COG) trial ANBL0532. STUDY DESIGN: A retrospective analysis of mIBG scans obtained from patients enrolled in COG ANBL0532 was performed. Evaluable patients had mIBG-avid, International Neuroblastoma Staging System (INSS) stage 4 disease, did not progress during induction therapy, consented to consolidation randomization, and received a tandem AHCT (n=80). Optimal CS cut points maximized the outcome difference (≤ vs >CS cut-off) according to the Youden index. RESULTS: For recipients of tandem AHCT, the optimal cut point at diagnosis was CS=12, with superior EFS from study enrollment for patients with CS<12 (3-year EFS 74.2±7.9%) vs CS>12 (59.2±7.1%) (p=0.002). At EOI, the optimal cut point was CS=0, with superior end-induction EFS for patients with CS=0 (72.9±6.4%) vs CS>0 (46.5±9.1%) (p=0.002). CONCLUSION: In the setting of tandem transplantation for children with high-risk neuroblastoma, Curie scores at diagnosis and end-induction may identify a more favorable patient group. Patients treated with tandem AHCT who exhibited a CS<12 at diagnosis or CS=0 at EOI had superior EFS compared to those with CS above these cut points.
11 Jan 2023Submission Checks Completed
11 Jan 2023Assigned to Editor
11 Jan 2023Submitted to Pediatric Blood & Cancer
13 Jan 2023Review(s) Completed, Editorial Evaluation Pending
14 Jan 2023Reviewer(s) Assigned
02 Feb 2023Editorial Decision: Revise Major
13 Apr 2023Submission Checks Completed
13 Apr 2023Assigned to Editor
13 Apr 20231st Revision Received
13 Apr 2023Review(s) Completed, Editorial Evaluation Pending
13 Apr 2023Reviewer(s) Assigned
27 Apr 2023Editorial Decision: Accept