{"entity":{"id":"tandem-transplant","kind":"technology","name":"Tandem autologous transplant","aka":[],"tldr":"Tandem transplant gives two back-to-back rounds of marrow-destroying chemotherapy, each rescued with the child's own stored stem cells, for high-risk neuroblastoma in North America. It kept more children relapse-free than one transplant in a randomised trial, but adds organ toxicity and hearing loss.","summary":"COG ANBL0532: tandem thiotepa-cyclophosphamide then carboplatin-etoposide-melphalan improved 3-year EFS versus single transplant (61.6% vs 48.4%), and the benefit held with anti-GD2 immunotherapy. In Europe (SIOPEN HR-NBL1), busulfan-melphalan single transplant is standard. Toxicity and cost are substantial.","status":"standard-of-care","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT00567567: COG ANBL0532","url":"https://clinicaltrials.gov/study/NCT00567567"}],"tags":[],"related":[],"cancers":["neuroblastoma","neuroblastoma-high-risk"],"sections":["chemotherapy","cell-therapy"],"technologies":["autologous-stem-cell-transplant"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["anbl0532"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Sequential myeloablative regimens exploit dose intensity against residual disease after induction and surgery, each rescued with cryopreserved autologous stem cells.","strengths":["EFS benefit in a randomised trial","Compatible with subsequent immunotherapy"],"limitations":["Cumulative organ toxicity and hearing loss","Not adopted in Europe; single BuMel used instead"],"since":2016},"route":"/technologies/tandem-transplant/","neighbours":{"cancer":[{"id":"neuroblastoma-high-risk","kind":"cancer","name":"High-risk neuroblastoma","route":"/cancers/neuroblastoma-high-risk/"},{"id":"neuroblastoma","kind":"cancer","name":"Neuroblastoma (paediatric)","route":"/cancers/neuroblastoma/"}],"section":[{"id":"cell-therapy","kind":"section","name":"Cell Therapy","route":"/fronts/cell-therapy/"},{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"}],"technology":[{"id":"autologous-stem-cell-transplant","kind":"technology","name":"Autologous stem cell transplant (high-dose therapy)","route":"/technologies/autologous-stem-cell-transplant/"}],"trial":[{"id":"anbl0532","kind":"trial","name":"COG ANBL0532","route":"/trials/anbl0532/"}],"bottleneck":[{"id":"b-rare-cancers","kind":"bottleneck","name":"Rare and paediatric cancers without markets","route":"/bottlenecks/b-rare-cancers/"}],"roadmap":[{"id":"paediatric-oncology-roadmap","kind":"roadmap","name":"Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first","route":"/roadmaps/paediatric-oncology-roadmap/"}]}}