A Case of Autologous Cord Blood Stem Cell Transplantationin Stage IV Neuroblastoma

Chae, Jung Hyun; Kim, Hyo Sun; Kwon, Seung Yeon; Won, Sung Chul; Kim, Bum Sik; Choi, Seong Yeol; Lyu, Chuhl Joo

Abstract

Since High dose chemotherapy (HDCT) with autologous hematopoietic stem cell (HSC) rescue has been reported to be the most effective current treatment modality in advanced and refractory neuroblastoma, various types of multiple tandem transplantation has been tried to improve survival of these patients. Autologous peripheral blood stem cell (PBSC) is the most commonly used hematopoietic stem cell source for HDCT in solid tumors owing to its availability and rapid engraftment. However, in case of insufficient stem cell harvest, it is difficult to go on multiple transplantations requiring alternative source of HSC. Umbilical cord blood stem cell (UCBSC) is one of the promising sources of HSC nowadays; however, its autologous use in HSC transplantation is a very rare procedure with only few of previous reports. Here we present a case of 2-year-old boy with stage IV neuroblastoma who underwent 3 cycles of sequential HDCT followed by HSCT using autologous PBSC and UCBSC, which we think as the first case report of autologus UCBSC transplantation in pediatric solid tumor performed in Korea. Since the banking of UCB for autologous usage is still very controversial issue, we discuss the safety and feasibility of this procedure as well as some of the uncertainties surrounding autologous cord blood collection and usage.