CEM (carboplatin, etoposide, melphalan) high-dose conditioning
Checked 2026-09-09
High-dose chemotherapy before autologous stem cell rescue in high-risk neuroblastoma, the Children's Oncology Group standard compared against BuMel in HR-NBL1
Also called CEM.
One cycle
weekly × 1 · about 1 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Carboplatin Cytotoxic chemotherapy (platinum) | dosed to renal function (target AUC) daily for four days | IV | D1-4 | |
Etoposide Topoisomerase II inhibitor (podophyllotoxin derivative) | 338 mg/m² daily for four days | IV | D1-4 | |
Melphalan Alkylating agent (nitrogen mustard) | 70 mg/m² daily for three days | IV | D1-3 |
Cycles
1
7-day cycle
Emetogenicity
High (>90%)
G-CSF
Built into the protocol
Notes
- In HR-NBL1 CEM was inferior to BuMel on event-free survival and caused more severe toxicity; it remains in use in some North American protocols.
Used in
Source
Ladenstein (HR-NBL1/SIOPEN), Lancet Oncology 2017: busulfan and melphalan versus CEM
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.