Abstract:Objective To evaluate the effects and regimen-related toxicity (RRT) of CEM (carboplatin, etoposide, melphalan) chemotherapy as a conditioning regimen in autologous peripheral blood stem cell transplantation (APBSCT) in children with high-risk neuroblastoma. Methods Six patients in stage IV neuroblastoma, who had gotten a complete remission after receiving high-dose chemotherapy, radiation and surgery were enrolled in this study. All the patients received CEM chemotherapy (carboplatin 425 mg/m 2 per day for 4 days; etoposide 338 mg/m 2 per day for 4 days; melphalan 70 mg/m 2 per day for 3 days) as a conditioning regimen in APBSCT. Transplantation related complications were observed and RRT was graded according to Bearman's proposal. Results The RRT was principally manifested as stomatitis (grade I in 6 cases) and gastrointestional symptoms (grade I in 5 cases and grade II in 1), and only 1 case had RRT in liver (grade I). The RRT symptoms were improved about 16 days after transplantation. The amount of white blood cells was recovered to over 1×10 9/L after about 33 days of transplantation. The follow-up visit (ranging from 8 months to 48 months ) revealed that five patients had event free survival and 1 died due to brain metastasis after APBSCT. Conclusion CEM chemotherapy as a conditioning regimen in APBSCT might be effective and safe for children with high-risk neuroblastoma.
