Pediatric transplantation: results in solid tumors

Solid tumors are one of the leading causes of disease-related mortality in children today. Although overall survival of children with solid tumors has improved over time, certain high-risk patients continue to respond poorly to conventional therapy. Recent studies have investigated using dose-intensified myeloablative therapy with autologous hematopoietic progenitor cell transplantation (AHPCT) in hopes of eradicating disease and improving the long-term survival of these patients. Results of high-dose therapy with AHPCT have been encouraging in treatment of metastatic neuroblastoma and recurrent Wilms' tumor, but little benefit has been demonstrated with Ewing's sarcoma. In this article, we examine the role of autologous transplant with each solid tumor and discuss some of the recent transplant-related controversies still under debate.