Therapy for Children With Advanced Stage Neuroblastoma

Inclusion Criteria

• •Participants \<19 years of age (eligible until 19th birthday).
• •Newly diagnosed, advanced stage, high-risk neuroblastoma defined as one of the following:
• •* Children \< 1 year with International Neuroblastoma Staging System (INSS) stage 2a, 2b, 3, 4 or 4S disease AND MYCN amplification (\>10 copies, or greater than four-fold increase in MYCN signal as compared to reference signal).
• •* INSS 2a or 2b disease AND MYCN amplification, regardless of age or additional biologic features
• •* INSS stage 3 AND:
• •1. MYCN amplification (\>10 copies, or greater than four-fold increase in MYCN signal as compared to reference signal, regardless of age or additional biologic features
• •2. Age \> 18 months (\> 547 days) with unfavorable pathology, regardless of MYCN status
• •* INSS stage 4 and:
• •1. MYCN amplification, regardless of age or additional biologic features
• •2. Age \> 18 months (\> 547 days) regardless of biologic features
• •3. Age 12 - 18 months (365 - 547 days) with any of the following three unfavorable biologic features (MYCN amplification, unfavorable pathology and/or DNA index =1) or any biologic feature that is indeterminant/unknown
• •* Children at least 365 days initially diagnosed with: INSS stage 1, 2, 4S who progressed to a stage 4 without interval chemotherapy.
• •Histologic proof of neuroblastoma or positive bone marrow for tumor cells with increased urine catecholamines.
• •Adequate renal and hepatic function (serum creatinine \<3 x upper limit of normal for age, AST\< 3 x upper limit of normal).
• •No prior therapy, unless an emergency situation requires local tumor treatment (discuss with principal investigator).
• •Written, informed consent according to institutional guidelines.
• •Potential donor is a biologic parent
• •Potential donor is at least 18 years of age.