Gavin received Chemotherapy Protocol COG-99703.  COG stands for Children’s Oncology Group.

The first phase consists of 3 rounds of “regular” chemotherapy using drugs called Cisplatin, Vincristine, Cylcophosphamide, and Etoposide.  The chemotherapy is administered over 4 days in hospital, then 2-3 weeks at home with clinic visits each week.

The second phase is 3 rounds of “high dose” chemotherapy using drugs called Carboplatin and Thiotepa. The high-dose phase is carried out through a bone marrow transplant. The patient receives extremely high doses of chemotherapy, followed by autologous stem cell rescue, and is kept in an isolation room for weeks at a time. This is done to reduce the risk of infection, as the white blood cell counts take much longer than normal to recover.

The stem cells used in Gavin’s treatment were his own.  He was given very high doses of G-CSF, a drug normally used to help bone marrow recover from chemotherapy, causing his system to over-produce stem cells.  The superfluous stem cells are released into the bloodstream where they can be collected through apheresis, which is similar to dialysis.

Gavin did not receive any radiotherapy, as our oncology team felt that the risks of delivering this therapy at his young age outweighed the benefits.

The neuro-oncology team at the Hospital for Sick Children in Toronto have published findings in using this protocol with a small group of AT/RT diagnoses, which was 8. Of the 8, only 6 received any active treatment, and there are 4 survivors from this group. Of the 4, only one was irradiated.

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