CONCLUSION
The role of CS as a prognostic marker in high-risk neuroblastoma patients undergoing tandem AHCT was examined in our study. We identified an optimal CS cut point both at diagnosis (CS≤12 vs>12) and EOI (CS=0 vs CS>0), and demonstrated that patients with CS at or below those cut points have potentially more favorable outcomes. The role of CS as a prognostic indicator in tandem AHCT patients will require validation in future COG high-risk neuroblastoma trials, including the current COG trial, COG ANBL1531. Ultimately, further improvements in outcome may depend on improved induction therapy regimen, either with the addition of targeted agents like131I-mIBG (COG ANBL1531) or anti-GD2 antibody (COG ANBL2131).