San Antonio has a multidisciplinary program devoted to the treatment of childhood malignancies. It is composed of personnel at the University of Texas Health Science Center at San Antonio (UTHSCSA) and the Santa Rosa Children's Hospital. The goal of this project is to enroll eligible and evaluable patients on Children's Cancer Study Group (CCSG) related studies. The proposed program will provide the administrative support to capture the maximum amount of data on each registered patient. This goal will be accomplished by CCSG operations support and efficient utilization of UTHSCSA resources and community physician in the major west Texas cities of San Antonio, Laredo, Lubbock, El Paso, and McAllen. The Principal Investigator will coordinate the activities at UTHSCSA with the affiliate members. Through this mechanism, San Antonio will continue to enroll patients on CCSG and Inter-group studies (41 over the past 12 months). The San Antonio center is an active contributor to many CCSG activities. Dr. P. Zeltzer is the chairman, Protocol CCG 921-Residual Disease Medulloblastoma, and a member of CCG 107-Acute Lymphoblastic Leukemia in Infants, and CCG 088-m-AMSA for Recurrent Neuroblastoma. He is also a member of the Brain Tumor Strategy Group, the Cancer Control Program, and the Group Editorial Committee. Dr. Sammuel LeBaron is the neuropsychologist on the CCG 921 committee. San Antonio has developed innovative treatments for children with neoplastic diseases, such as: 1) the first American varicella vaccination program for children with leukemia and lymphoma, conducted by Drs. Brunell and Geiser; 2) NIH supported research on hypnosis and other modalities for relief of pain from procedures and side effects of chemotherapy, conducted by Drs. L. Zeltzer and S. LeBaron; 3) preclinial studies of medulloblastoma and neuroblastoma using flow cytometry, cloning, cytochemical and neurochemical methods. The San Antonio center also has demonstrated that a newly discovered tumor isoenzyme, neuronal specific enolase (NSE), is a powerful marker for Stage IV neuroblastoma at diagnosis and is prognostic for infants less than one year of age. Drs. P. Zeltzer and Von Hoff are piloting an exciting trial for recurrent neuroblastoma, comparing the in vivo response with in vitro stem cell sensitivity to m-AMSA in CCG 088. This is truly a multidisciplinary team which is making innovative contributions to the diagnosis and treatment of childhood cancer.