Application of tandem peripheral blood stem cell transplantation in children neuroblastoma treatment

Summary. Despite significant advances made over the past several decades in the treatment of malignant solid tumors in children, the results of treatment of patients with high-risk neuroblastoma are few satisfactory. Purpose is to consider the possibility, safety and features of tandem high-dose chemotherapy in the treatment of children with high-risk neuroblastoma.From 2012 to intensify treatment, we used double (tandem) high-dose chemotherapy in 9 patients. The first element tandem chemotherapy was busulfan and melphalan. CPCS transfusion was performed at a dose of 2,9–4,3×10 CD34+ cells per kilogram of patient. The second element of transplantation was topotecan and cyclophosphamide. CPCS transfusion was performed at a dose of 3,0–7,0×10 CD34+ cells per kilogram of body weight. The second element was carried out at intervals of 2.1 months (1,8–3,0 months). The first element of chemotherapy, patients underwent satisfactorily. Febrile neutropenia was observed in 5 of 9. Leukocytic engraftment reached at 9–12 days, platelet — 12–34 days.