Double high-dose chemotherapy with autologous peripheral stem cell rescue in relapsed Wilms' tumor

We performed double high-dose chemotherapy (HDCT) and autologous stem cell rescue (ASCR) on an 8-year-old girl after relapse of Wilms' tumor with unfavorable histology. Relapse occurred while the patient was still on first-line therapy and showed multiple adverse prognostic features. Since depleted hematopoietic reserves restricted further conventional therapy, a double HDCT approach was chosen to achieve maximal dose intensity. Four years after relapse the girl is in second remission and well. Double HDCT with ASCR may represent a feasible approach to rescue extensively pretreated patients with recurrent Wilms' tumor of unfavorable histology.