Tandem high-dose chemotherapy and autologous hematopoietic stem cell transplantation in pediatric patients with high-risk neuroblastoma: single-center experience

Currently, the use high doses chemotherapy (HDC) supported by autologous peripheral blood stem cells in consolidation is a necessary therapeutic option in patients with high-risk neuroblastoma (NB). Conditioning regimens and schemes of HDC remain the subject of debate. In recent years, the evidence base of the advantages of tandem myeloablative procedures in comparison with single-transplantation has been actively accumulated in clinical practice. This article presents our own experience of tandem-transplantation with stem cell rescue in the N.N. Petrov National Medical Research Centre of Oncology (Saint-Petersburg) in four patients with initially stratified high-risk group NB; two of them were NMYC amplified. Tandem consolidation included TC ([T]hiotepa, [C]yclophosphamide) and CEM ([C]arboplatin, [E]toposide, [M]elphalan) regimens. The acceptable toxicity of the tandem-transplantation is proved.