In Vitro Chemosensitivity Test for Neuroblastoma Cells / 대한소아혈액종양학회지

ABSTRACT

PURPOSE: Neuroblastoma is the second common solid tumor in chidhood and has the worst prognosis in stage IV case. To improve the future survival rate in this disease the clinical and laboratory characteristics of patients, the characteristics and chemosensitivity test of cultured neuroblastoma cells and the outcome were compared. METHODS: The clinical characteristics including age, urinary catecholamines, serum ferritin, neuron specific enolase, pathology, stage, and patient's outcome were evaluated in four neuroblastoma patients diagnosed at the Department of Pediatrics, Kyungpook National Univesity Hospital. The neuroblastoma cells obtained from tumor or bone marrow cells were cultured and used for immunobead test using mononuclear antibody, biochemical analysis, N-myc oncogene copy, chromosome study and chemosensitivity test. Cyclophosphamide, cisplatin, doxorubicin, etoposide, ifosfamide and melphalan were used in chemosensitivity test. The statistical analyses were done by chi2-method. RESULTS: The age of patients were 6~31 (mean; 18) months. The adrenal gland was the primary site and the stage was IV in all cases. In laboratory data, serum ferritin level were 40~352 (204) ng/mL, neuron specific enolase 45~167 (107) ng/mL, urinary excretion of HVA 1.8~268 (73) mg/day, of VMA 0.2~345 (87) mg/day and the HVA/VMA ratio 0.8~67 (20). Cultured neuroblastoma cells and immunobeads attached around the cell were observed. The partial deletion of short arm or monosomy of chromosome 1, double minutes or homogenous stained region were found in three patients. N-myc oncogene copy was positive in one of two tested. Radical surgery was done in three patients and chemotherpy and radiotherpy by CCG-3881 or -3891 were given in four patients. The duration of survival in three died patients were 6~13 (mean; 10) months. One is survived in relapse-free state for 52 months. In chemosensitivity test, the neuroblastoma cell of survivor was highly sensitive in all drugs compared to the neuroblastoma cell of relapsed patients. CONCLUSION: Normal serum ferritin level or normal chromosome were correlated as a good prognostic factors in survivor compare in relapsed patients. In chemosensitivity test, the neuroblastoma cells of survivor were higher sensitive to all drugs compare to those of relapsed patients. The chemosensitivity test of this method were relatively simple and could be used in selection of anticancer drug and as a prognostic factor in neuroblastoma.