# Tandem autologous transplant

Source: https://onco.cc/technologies/tandem-transplant/  
OnCo record `tandem-transplant` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Tandem transplant gives two back-to-back rounds of marrow-destroying chemotherapy, each rescued with the child's own stored stem cells, for high-risk neuroblastoma in North America. It kept more children relapse-free than one transplant in a randomised trial, but adds organ toxicity and hearing loss.

## Summary

COG ANBL0532: tandem thiotepa-cyclophosphamide then carboplatin-etoposide-melphalan improved 3-year EFS versus single transplant (61.6% vs 48.4%), and the benefit held with anti-GD2 immunotherapy. In Europe (SIOPEN HR-NBL1), busulfan-melphalan single transplant is standard. Toxicity and cost are substantial.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-07
- Principle: Sequential myeloablative regimens exploit dose intensity against residual disease after induction and surgery, each rescued with cryopreserved autologous stem cells.
- Since: 2016
- Strengths: EFS benefit in a randomised trial; Compatible with subsequent immunotherapy
- Limitations: Cumulative organ toxicity and hearing loss; Not adopted in Europe; single BuMel used instead

## Sources

- ClinicalTrials.gov NCT00567567: COG ANBL0532: https://clinicaltrials.gov/study/NCT00567567

## Connected records

- cancers: [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/)
- fronts: [Cell Therapy](https://onco.cc/fronts/cell-therapy/), [Chemotherapy](https://onco.cc/fronts/chemotherapy/)
- technologies: [Autologous stem cell transplant (high-dose therapy)](https://onco.cc/technologies/autologous-stem-cell-transplant/)
- trials: [COG ANBL0532](https://onco.cc/trials/anbl0532/)
- bottlenecks: [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/)
- roadmaps: [Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first](https://onco.cc/roadmaps/paediatric-oncology-roadmap/)

---
JSON: https://onco.cc/api/v1/entities/tandem-transplant.json