Cancers & treatments·Regimen libraryConditioning

CEM (carboplatin, etoposide, melphalan) high-dose conditioning

Checked 2026-09-09

High-dose chemotherapy before autologous stem cell rescue in high-risk neuroblastoma, the Children's Oncology Group standard compared against BuMel in HR-NBL1

Also called CEM.

One cycle

weekly × 1 · about 1 weeks in total

7-day cycle × 1 (about 1 weeks)Intravenous

Components

Drug	Dose	Route	Days
Carboplatin Cytotoxic chemotherapy (platinum)	dosed to renal function (target AUC) daily for four days	IV	D1-4
Etoposide Topoisomerase II inhibitor (podophyllotoxin derivative)	338 mg/m² daily for four days	IV	D1-4
Melphalan Alkylating agent (nitrogen mustard)	70 mg/m² daily for three days	IV	D1-3

Cycles

7-day cycle

Emetogenicity

High (>90%)

G-CSF

Built into the protocol

Notes

In HR-NBL1 CEM was inferior to BuMel on event-free survival and caused more severe toxicity; it remains in use in some North American protocols.

Used in

Neuroblastoma (paediatric)

Products

CarboplatinEtoposideMelphalan (including hepatic delivery system)

Source

Ladenstein (HR-NBL1/SIOPEN), Lancet Oncology 2017: busulfan and melphalan versus CEM

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers

BuMel (busulfan, melphalan) high-dose conditioning

High-dose chemotherapy before autologous stem cell rescue in high-risk neuroblastoma (SIOPEN HR-NBL1)

weekly × 1

All regimens OEPA (vincristine, etoposide, prednisone, doxorubicin) →