High dose chemotherapy with autologous stem cell rescue for patients with medulloblastoma

High-dose chemotherapy with autologous stem cell rescue (ASCR) is a promising strategy for patients with poor prognosis cerebellar medulloblastoma. For this strategy to be effective, it must be shown that the medulloblastoma tumor cells are sensitive to the chemotherapeutic agents whose dose-limiting toxicity is hematopoietic, and stem cells must be available that are free of contaminating tumor. Several protocols for high-dose chemotherapy followed by ASCR are presented in this chapter. Initial encouraging evaluations of this technique in patients with recurrent disease has prompted testing of its feasibility in infants and young children. In a reasonably short time, the role of high-dose chemotherapy with ASCR will be determined for subgroups of patients with medulloblastoma.