High-Dose Chemotherapy and Stem Cell Transplant in Treating Patients with High-Risk Neuroblastoma

Inclusion Criteria

• End of induction disease evaluation demonstrating complete response (CR), partial response (PR), mixed response (MR) or stable disease (SD)
• Hematopoietic recovery from last induction course of chemotherapy (absolute neutrophil count [ANC] > 500 and platelet > 20,000)
• No uncontrolled infection
• Minimum frozen PBSCs of 2 x 10^6 cluster of differentiation (CD)34 cells/kg for each transplant are mandatory and a PBSC of 2 x 10^6 CD34 cells/kg for back-up are strongly recommended (thus, PBSC of no less than 6 x 10^6 CD34 cells/kg is encouraged); these must all be collected prior to the initiation of consolidation
• Aspartate aminotransferase (AST) < 3 x upper limit of institutional normal (ULN); alanine aminotransferase (ALT) =< 3 x ULN for age
• Total bilirubin =< 1.5 x ULN for age, if baseline was normal, > 1.0-1.5 x baseline if baseline was abnormal
• Shortening fraction >= 27% or ejection fraction >= 45%, no clinical congestive heart failure
• No evidence of dyspnea at rest and no requirement for supplemental oxygen
• Creatinine clearance or glomerular filtration rate (GFR) > 60 mL/min/1.73 m^2; if a creatinine clearance is performed at end induction and the result is < 100 ml/min/1.73 m^2, a GFR must then be performed using a nuclear blood sampling method or iothalamate clearance method; camera method is NOT allowed as measure of GFR prior to or during consolidation therapy for patients with GFR or creatinine clearance of < 100 ml/min/1.73 m^2
• Recovery from acute toxicities of last cycle of induction chemotherapy
• Appropriate written consent – adult or parent/guardian if patient is < 18 years of age and minor information sheet if patient is > 8 years of age