Unfortunately, in spite of very intensive chemotherapy and total body irradiation in the conditioning regimens prior to transplant for most cancers, the relapse rate remains very high, anywhere from 10 percent to 50 percent.
Experts at the UCSF Benioff Children's Hospital Bone Marrow Transplant Program are evaluating potential approaches to reduce the relapse rate after bone marrow transplant in patients with leukemia or high-risk neuroblastoma.
One approach for leukemia is to use donor T lymphocyte infusions (DLI) at various times after the transplant. In addition, we carefully monitor patients for any evidence of early relapse.
For patients with high-risk neuroblastoma, an autologous transplant results in a cure for approximately 40 percent of patients. However, the relapse rate after a bone marrow transplant is 50 percent. In order to reduce this relapse rate, children may be eligible for treatment with special monoclonal antibodies that target any remaining neuroblastoma cells, or children may be eligible for different protocols using additional chemotherapy and or radiation with stem cell support.