Clinical Report on the Treatment of Children with Advanced Neuroblastoma with Autologous Haematopoietic Stem Cell Transplantation.

Neuroblastoma(NB) is a common solid tumors in children. Even with active chemotherapy, operation and irradiation, the survival rate is still very low in advanced patients. To improve the treatment results, autolougous haematopoietic stem cell transplantations have been performed in 11 patients with advanced NB in our hospital. The average age was 3.8 years old (2–6 years old) and the average weight was 15.3kg(11.6–20kg) in this group. All 9 patients were in stage IV with the primary mass in abdomen and extensive bone marrow involvement but 2 patients in stage III with the primary mass in thorax. Although high dose chemotherapy and active operation was given, 4 cases still have not got complete remission at the time of transplant. As 2 cases received 2 times transplant, totally 13 transplants were performed in these 11 children. 3 were collected stem cell from the anterior crista of iliac in both sides while another 10 were received the stem cell from the peripheral mononuclear cell harvested with CS-3000 cell separator after G-CSF mobilization. To reduce the risk of post transplant relapse, 4 cases were purged with CliniMACS based on the CD34 positive selection. All the patients conditioned with Etopside plus Carboplatin plus Melphalan. Results show the number of mononuclear cell collected from bone marrow or peripheral blood was equal to 5.7±0.9′10⁸/kg and 5.7±1.0′10⁸/kg respectively(p>0.05). All of them achieved the haematopoietic reconstitution after transplantation. The mean time for the neutrophile count recovering to 0.5 ′10⁹/L was 10.5±5.7 days and the platelet recovering over 2.0 ′10⁹/L. The mean transfusion independent day was 16.8±9.4 days with average 2 units of packed red blood cells and 4 units of platelet products transfused in the course of transplantation. The mean fellow up time was 26.7 months. 4/11 children died of relapse 5 months to 27 months after transplantation. Other 7 children are still in survival. None of our children died of complication associated with transplantation. It suggests autologous stem cell transplantation is a safe and effective measure in the treatment of children with advanced neuroblastoma and worth of further recommendation.