# ANBL0532: tandem versus single autologous stem cell transplant for high-risk neuroblastoma

Source: https://onco.cc/key-papers/paper-anbl0532-tandem-transplant-park-jama-2019/  
OnCo record `paper-anbl0532-tandem-transplant-park-jama-2019` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Two consecutive high-dose chemotherapy courses with stem cell rescue improved three-year event-free survival compared with a single transplant in high-risk neuroblastoma, and the gain was largest in children who went on to receive anti-GD2 immunotherapy.

## Summary

Children's Oncology Group phase 3 trial of 652 children with high-risk neuroblastoma, of whom 355 were randomised after induction to single transplant (carboplatin-etoposide-melphalan) or tandem transplant (thiotepa-cyclophosphamide followed by carboplatin-etoposide-melphalan).

Three-year event-free survival was 61.6 versus 48.4 percent; overall survival did not differ significantly (74.1 versus 69.6 percent); among patients receiving immunotherapy, event-free survival was 73.7 versus 56.0 percent.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: JAMA
- Year: 2019
- DOI: 10.1001/jama.2019.11642
- Authors: Park JR, Kreissman SG, London WB, et al.
- Findings: Three-year event-free survival 61.6 percent vs 48.4 percent.; With post-consolidation immunotherapy: 73.7 percent vs 56.0 percent.
- What it means: Tandem transplant is the standard consolidation in North American protocols for high-risk neuroblastoma; Europe uses single busulfan-melphalan.
- Caveats: Only about half of enrolled patients reached randomisation.; No significant overall survival benefit.

## Sources

- JAMA 2019: https://doi.org/10.1001/jama.2019.11642
- PubMed: https://pubmed.ncbi.nlm.nih.gov/31454045/

## Connected records

- cancers: [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/)
- trials: [COG ANBL0532](https://onco.cc/trials/anbl0532/)
- journals: [JAMA](https://onco.cc/journals/jama/)

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