Sequential high-dose chemotherapy with autologous stem cell rescue for children with high-risk medulloblastoma and supratentorial primitive neuroectodermal tumours

10019 Background: Prognosis of high-risk meduloblastoma (HR MB) and supratentorial primitive neuroectodermal brain tumours (sPNET) is poor. In an attempt to improve outcome, we have developed strategies based on sequential high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT) and radiotherapy for thirteen years. Patients and methods: Seventy-nine children (median age, 3.95 years) were treated with HDC/ASCT (59 HR MB; 20 sPNET). All patients received induction chemotherapy with one or two cycles of carboplatin-etoposide. Treatment strategy was modified with time and according to the age. Eighteen children were treated by two courses of high dose melphalan (100mg/m2) and one course of busulfan thiotepa combination (regimen 1). Two myeloablative courses of melphalan (100mg/m2) with ASCT were performed in twenty-one children (regimen 2). Nine patients were planned to receive two courses of high dose thiotepa (600mg/m2;) with ASCT (regimen 3). Thirty-one children received five se...