The Efficacy Of Autologous Stem Cell Transplants To Treat High Risk Neuroblastoma

Abstract

High Risk Neuroblastoma is a pediatric cancer that arises from immature nerve cells. While low and intermediate risk neuroblastomas remain curable with high survival rates, high risk neuroblastoma (HRNB) patients have less than a 50 percent chance of survival. Due to this disparity HRNB patients undergo intense multimodal treatment, while researchers attempt to find the best variants and combinations of treatments that will improve this statistic. One factor of interest in treatment is the autologous stem cell transplant (ASCT). ASCT have been found to improve event free survival (EFS) when compared to continuing chemotherapy, however overall survival (OS) rates remain unchanged. Similarly, tandem ASCT has improved EFS significantly compared to a single transplant, while OS remains the same. While OS is the standard for measuring the efficacy of oncological treatments, with a cancer as aggressive as HRNB improved EFS is satisfactory. Thus, single transplants should be continued, and tandem transplants should be implemented when indicated. characteristics, including MYCN , contemporary induction, and pre-minimal residual disease (MRD)-positivity. This suggest that there is a need for reevaluation of stem cell transplants in the treatment of HRNB. concludes that ASCT does not have a significant effect on improving EFS or OS when local RT, anti-GD2 and are used for consolidation after dose-intensive induction chemotherapy and suggests reevaluating the use of ASCT in treating HRNB