Should I randomise for tandem transplant in the High‑Risk Neuroblastoma 2 trial? 

Deciding whether to take part in randomisation within the High‑Risk Neuroblastoma 2 trial is a personal decision, and one that should always be made in discussion with your child’s medical team. One of the randomisations in the trial is comparing two different approaches to consolidation treatment. Both approaches are already used in the treatment of high-risk neuroblastoma globally, however, we do not know yet which is better at helping children in the long term. 

What the randomisation involves 

As part of the consolidation phase, families may be asked whether they agree to randomisation between: 

• A single transplant using Busulfan and Melphalan 

• A tandem transplant, which is two cycles of high-dose chemotherapy:  
  • Thiotepa 
  • Followed by Busulfan and Melphalan 

Both treatments aim to improve long‑term outcomes, but it is not yet known which approach is more effective, which is why research like this is important. 

If you agree to take part, the assignment is made by a computer at random - neither you nor the clinical team choose which option your child receives. 

What if I choose not to randomise? 

If you decide not to take part in this part of the trial, your child will continue with standard‑of‑care treatment, which is a single transplant using Busulfan and Melphalan. Your child’s care will not be affected in any negative way. 

How to make the decision 

Your child’s medical team will talk you through: 

• The potential benefits and uncertainties 

• What each transplant approach involves 

• The expected timeline 

• Short‑term and long‑term considerations 

• What monitoring and follow‑up will look like 

You can ask for the information to be repeated, broken down in simpler terms, or provided in writing. Many families also find it helpful to prepare a list of questions before discussions. 

What taking part means  

Taking part in randomisation simply means that your child’s treatment is allocated by chance between two options that are both already used as part of standard care for high‑risk neuroblastoma. Randomisation allows researchers to compare these approaches fairly, but there is no expectation or obligation for families to take part. 

Choosing not to randomise will not affect your child’s care, their treatment plan, or the support you receive. Your child will continue with the standard approach of a single transplant using Busulfan and Melphalan.