Is there evidence-based benefit of autologous stem cell transplantation in children with solid tumors?

Multidisciplinary care, a better understanding of tumor biology, and advances in chemotherapy have dramatically improved the prognosis of solid tumors in children. The diseasefree survival (DFS) has increased over the last three decades from <20 to 30% in the early 1970s to now 70% after 5-10 years of follow-up [1]. This progress has been limited to patients with localized tumors. However, a subset of children with advanced, therapy-resistant or relapsed disease has not derived any benefit from these advances. Despite multimodal conventional therapy, for example in newly diagnosed highrisk neuroblastomas, Ewing family tumors, metastatic rhabdomyosarcomas, or high-grade gliomas, the probability of long-term survival has remained poor, with less than 30%. After tumor progression or recurrence following adequate initial treatment, even less than 10% of patients with solid tumors survived [2].