She required bilateral nephrectomies for multiply recurrent disease. She received CRB doses based upon pharmacokinetic analysis. On completing 5 cycles of chemotherapy with HD support she had no evidence of disease. For transplant, CRB dose was based upon prior pharmacokinetics. CY was not dose adjusted.
Conditioning regimen is shown in a table.
She had only mild mucositis and suffered no infections or toxicities to major organ systems. Despite another local recurrence, she survives 565 days post-transplant. Given the lack of toxicity in this patient, increased doses of the drugs used in this preparative regimen may be possible for anephric children. Despite the remarkable success in treatment of Wilms' tumour there is still a small group who will suffer from relapse. The optimal therapy for relapsing Wilms tumour has not been determined.