Reduced tumor load in peripheral blood after treatment with G-CSF and chemotherapy in children with tumors of the Ewing sarcoma family but not neuroblastoma

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Abstract
Using reverse-transcriptase polymerase chain reaction (RTPCR)4 for tyrosine hydroxylase (TH) mRNA, tumor cells in PB samples from 6 of 8 children with NBL have been detected following mobilization of stem cells with chemotherapy and granulocyte colony-stimulating factor (G-CSF) (Figure 1A), and EWS-FLI1 fusion transcripts in samples from 7 of 7 children with tumors of the Ewing sarcoma family (ESFT), including 5 of 5 Ewing sarcomas (ES) and 2 of 2 peripheral primitive neuroectodermal tumors (pPNETs) (Figure 1B). No EWS-WT1 fusion transcripts were identified in PB from one child with a desmoplastic small round-cell tumor (DSRCT) (Figure 1B, child 16). All children were entered into multicenter trials using recommended chemotherapy. On day 5 after the start of chemotherapy, children were treated with recombinant G-CSF (5 μg/kg per day) for 10 days to mobilize stem cells into PB over 4 courses. PB samples taken at intervals (between days 5 and 15 of each course) from the central venous line were analyzed for contaminating tumor cells by RT-PCR: all primary neuroblastomas expressed TH mRNA, all ESFTs expressed EWS-FLI1 fusion transcripts, and the EWS-WT1 fusion product was confirmed in the DSRCT.