HIGH-DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM-CELL RESCUE FOR PATIENTS WITH MEDULLOBLASTOMA

High-dose chemotherapy with autologous stem cell rescue (ASCR) is a pr omising strategy for patients with poor prognosis cerebellar medullobl astoma. For this strategy to be effective, it must be shown that the m edulloblastoma tumor cells are sensitive to the chemotherapeutic agent s whose dose-limiting toxicity is hematopoietic, and stem cells must b e available that are free of contaminating tumor. Several protocols fo r high-dose chemotherapy followed by ASCR are presented in this chapte r. Initial encouraging evaluations of this technique in patients with recurrent disease has prompted testing of its feasibility in infants a nd young children. In a reasonably short time, the role of high-dose c hemotherapy with ASCR will be determined for subgroups of patients wit h medulloblastoma.