High-dose chemotherapy for neuroblastoma

High‑dose chemotherapy is an important part of treatment for children with high‑risk neuroblastoma. It is usually given after induction chemotherapy and surgery to destroy any remaining cancer cells and strengthen the chances of controlling the disease.

High‑dose chemotherapy is sometimes called consolidation therapy. The medicines most commonly used for neuroblastoma are busulfan and melphalan. These drugs are given at higher doses than standard chemotherapy to treat any cancer cells that may still be in the body.

Why high‑dose chemotherapy is needed 

Even after strong induction chemotherapy and successful surgery, tiny amounts of cancer can remain in the body. High‑dose chemotherapy aims to: 

• Destroy cancer cells that are difficult to detect on scans 
• Reach cancer cells that may be hiding in the bone marrow 
• Improve the chances of achieving long‑term remission 

Because the treatment is very intensive, it also affects healthy cells - particularly in the bone marrow, where blood cells are produced.

Stem cell rescue (autologous stem cell transplant) 

High‑dose chemotherapy causes a lot of damage to the bone marrow, which means the body cannot recover on its own. For this reason, children need a stem cell rescue, also known as an autologous stem cell transplant. 

This involves: 

1. Collecting your child’s own stem cells before high‑dose chemotherapy begins and storing them safely. 
2. Giving high‑dose chemotherapy over several days. 
3. Returning the stored stem cells to your child afterwards to help the body rebuild healthy blood cells. 

This process supports recovery of the immune system, red blood cells, and platelets. 

Read more about stem‑cell transplant for neuroblastoma.

Animated video on consolidation therapy for high-risk neuroblastoma

This video was produced as part of the SIOPEN High-Risk Neuroblastoma 2 Trial.