Tandem autologous transplant
Two rounds of very high-dose chemotherapy with stem-cell rescue, back to back, used in high-risk neuroblastoma in North America.
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.
How it works
Sequential myeloablative regimens exploit dose intensity against residual disease after induction and surgery, each rescued with cryopreserved autologous stem cells.
- EFS benefit in a randomised trial
- Compatible with subsequent immunotherapy
- Cumulative organ toxicity and hearing loss
- Not adopted in Europe; single BuMel used instead
Latest papers
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