Despite the development of new treatment options, the prognosis of high-risk neuroblastoma patients is still not good; in more than half of patients the disease returns. High-dose chemotherapy and haematopoietic stem cell rescue, also known as myeloablative therapy, might improve the survival of these patients. A well-informed decision on the use of myeloablative therapy in the treatment of children with high-risk neuroblastoma should be based on high quality evidence on both anti-tumour efficacy and adverse effects.
This systematic review focused on randomised studies comparing the effectiveness of myeloablative therapy with conventional therapy in children with high-risk neuroblastoma. The authors found three studies including 739 patients. These studies provide evidence that myeloablative therapy improves survival. However, adverse effects are more common in patients treated with myeloablative therapy. It should be noted that this systematic review only allows a conclusion on the concept of myeloablative therapy; no conclusions regarding the best treatment strategy with regard to, for example, types of chemotherapeutic agents and the use of radiation therapy, could be made. More high quality research is needed.