Аннотация:Background and Aims: Ewing sarcoma (ES) relapses are still a problem. Most of the patients have relapses in distant sites. New schemes of therapy required for improvement of outcomes. We aimed to analyze our experience in treatment of relapses of ES and propose personalized program of intensified treatment.Methods: Two hundred and seventy four patients treated during 2008-2020, 262 included to analysis. Age median 11.6 (6 months – 18 years) years. Age of the most of patients was between 11 and 17 years old. Forty eight patients among 262 (18,3%) with relapses included to our study. Most of the patients (70.8%) were with isolated, 39.6% – with combined and 14.5% - with local relapses. Metastatic lung disease was found in 66.6%. Second-line therapy was used in case of early relapses with VIT/VCT schemes. Intensified scheme of primary treatment (shorten intervals) was used in case of late relapses.Results: In the median of follow-up 39,3 months OS of the group with relapses was 53 ± 8,1%. After the completion of treatment second relapse diagnosed only in 9 patients. VIT response rate was 60% and VCT – 39%. In this regard, to intensify therapy we proposed a new program with autologous hematopoietic stem cell transplantation (aHSCT) with treosulfan and melphalan conditioning. Ten patients treated with such scheme. With a median follow-up of 4.2 (2-9) months all patients are alive without progression. Depending on individual features we've adapting course intervals. Study continuous.Conclusions: ES relapses are still a problem. There is no golden standard. Possible successful approach for treatment is intensification and personalization of treatment with the help of aHSCT.