Abstract: Objective: To investigate the therapeuti effects of high dose chemotherapy combined with autologous pe -ripheral blood stem cell transplantation and immune treatment on 18cases of stage Ⅳneuroblastoma in children. Methods: Eighteen children with stage Ⅳneuroblastoma were collected. Before autologous peripheral blood stem cell transplanta -tion, 8 patients had complete remission, 6 patients had partial remission, and 4 case had progressive disease. These cases aged1.5 ~14.25years, with the median age of 6.415 years. Primary sites of the tumors included retroperitoneal ( n=5), ad-renal ( n=9), chest ( n=3), and chest-abdomen ( n=1). Before autologous peripheral blood stem cell transplantation, these pa-tients received 6 courses of intensive induction chemotherapy. During chemotherapy the autologous peripheral blood stem cells were harvested and the tumor was excised through surgery. IL- 2 immune therapy and 13-cis retinoid acid therapy were administered after transplantation. Patients with recurrence received secondary local radiation and regular chemother-apy. Results:After autologous peripheral blood stem cell transplantation,1 progressive case died of heart-lung failure. Sev-enteen patients underwent reinfusion and the restrain period of bone marrow. The amount of white blood cells was recov-ered to2 × 109 /L at 15~19days after transplantation. The follow-up (ranged from3 months to34.9 months, with an average of 15.89± 10.37months and the median of 13.8 months) revealed that 8 patients in CR had CR, 2 cases received chemo-therapy and local radiation for recurrence at 1 year after transplantation, 3 patients in PR had CR, and another3 cases in PR had PR. At 8 months after transplantation, 2 cases died of brain metastasis. Three progressive cases had partial remis -sion but died of tumor recurrence or function failure of important organs at 3, 4, and 6 months after transplantation, respectively. The disease-free survival (DFS) was 75% in CR,50% in PR, and0 in PD patients. The event-free survival and total survival rate of all patients were 50% and 66.7%, respectively. The disease-free survival was significantly different among the three groups ( P<0.05). Conclusion:High dose chemotherapy combined with autologous peripheral stem cell transplantation and immune therapy can achieve good outcome in patients with stage Ⅳneuroblastoma with CR. The outcome of patients with PR can be improved before transplantation. Patients with PD have poor prognosis.