Known as consolidation therapy, high-dose chemotherapy aims to ‘mop-up’ any remaining cancer cells that might be left over following induction chemotherapy and surgery.

This chemotherapy is known as 'myeloablative' and is high-dose. The term 'myeloablative' refers to the depletion of the blood-producing cells in the bone marrow as a side-effect. The drugs used in this process are called busulfan and melphalan.

Stem cell treatment

Giving higher doses of chemotherapy might be more effective in treating neuroblastoma but it causes severe damage to the bone marrow (where new blood cells are made). Doctors help children by replacing bone marrow cells - this is called stem cell transplant.

Isolation

Your child will be kept in isolation until they are no longer at risk of infection. They are at a high risk of infection because of their low white blood cell count.

To help lower the risk of infection, your child will stay in a special hospital room and care is taken you and family members visit.

Side-effects

High-dose chemotherapy can have severe life-threatening toxicities, occurring in 4% of patients.

Because the treatment requires several weeks in isolation while blood counts recover, the child is at risk of infection, and usually suffers from mouth sores and mucositis throughout the gastrointestinal tract. Children receive antibiotics, anti-fungal medications, and blood products. Often they are on nutritional support due to inability to eat.

Other adverse events include general condition, infection, stomatitis and veno-occlusive disease (VOD).

Studies continue to assess long term effects.