Inclusion Criteria:

- Patients <18 years old with newly diagnosed, advanced stage, high-risk neuroblastoma
defined as one of the following:

- Children < 1 yo 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 mo (> 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 less than or equal to 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) aspartate aminotransferase < 3 x upper limit of normal).

- No prior therapy, unless an emergency situation requires local tumor treatment
(discuss with PI)

- Written, informed consent according to institutional guidelines

Exclusion Criteria:

- Any evidence, as judged by the investigator, of severe or uncontrolled systemic
disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic, or renal
disease).

- Pregnant or breast feeding (women of child-bearing potential).

- Children with INSS 4 disease, age <12 months with all 3 favorable biologic features
(non-amplified MYCN, favorable pathology and DNA index >1).