{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:45:43Z","timestamp":1785415543654,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>\u00a0The majority of patients in low\u2010 and middle\u2010income countries (LMIC) are unable to receive optimal therapy, including autologous stem cell transplant (ASCT) for high\u2010risk neuroblastoma. Management is intensive and multidisciplinary; survival is often poor. We report a single\u2010center outcome of high\u2010risk neuroblastoma, with adaptations optimized for LMIC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>\u00a0The study was retrospective. Patients were treated on the backbone of the high\u2010risk neuroblastoma study\u20101 of SIOP\u2010Europe (HR\u2010NBL1\/SIOPEN) protocol with ASCT. Adaptations incorporated to decrease cost, requirement for inpatient admission, infections, and faster engraftment included (a) optional outpatient administration for rapid\u2010COJEC, (b) two sessions of stem\u2010cell apheresis, (c) storing stem cells at 2\u20106\u00b0C without cryopreservation for up to 7 days, (d) no central lines, (e) no antibacterial\/antifungal\/antiviral prophylaxis, (f) omitting formal assessment of cardiac\/renal\/pulmonary functions before ASCT, and (g) administration of pegylated granulocyte colony\u2010stimulating factor on Day +4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\u00a0Over 5 years 9 months, 35 patients with high\u2010risk neuroblastoma were treated. Rapid\u2010COJEC was administered over a median duration of 80 days (interquartile range: 77, 83). Conditioning regimen included melphalan (n\u00a0=\u00a07), oral busulfan\u2010melphalan (Bu\/Mel; n\u00a0=\u00a06), or intravenous Bu\/Mel (n\u00a0=\u00a022). The median viability of stem cells stored for 6 days (n\u00a0=\u00a028) was 93% (range: 88\u201099). Two (5.7%) patients had ASCT\u2010related mortality. The 3\u2010year overall and event\u2010free survival was 41% and 39%, respectively. A relapse occurred in 20 (57%) patients. Treatment abandonment was observed in one (3%) patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>\u00a0Administration of therapy in a disciplined time frame along with low\u2010cost adaptations enables to manage high\u2010risk neuroblastoma with low abandonment and an encouraging survival in LMIC. Stem cells can be stored safely without cryopreservation for up to 7 days.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28273","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T19:05:28Z","timestamp":1584731128000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Autologous stem cell transplant for high\u2010risk neuroblastoma: Achieving cure with low\u2010cost adaptations"],"prefix":"10.1002","volume":"67","author":[{"given":"Richa","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pediatric Hematology\u2010Oncology Unit Advanced Pediatrics Center  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rekha","family":"Hans","sequence":"additional","affiliation":[{"name":"Department of Transfusion Postgraduate Institute of Medical Education and Research  Chandigarh 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