Late effects in high-risk neuroblastoma survivors treated with high-dose chemotherapy and stem cell rescue

Pediatric Blood & Cancer
Mahmoud M ElzembelyK Scott Baker

Abstract

Current treatment strategies have improved the outcome of high-risk neuroblastoma (HRNB) at the cost of increasing acute and late effects of treatment. Although high-dose chemotherapy with stem cell rescue (HDC-SCR) has replaced total body irradiation (TBI) based HRNB therapy, late effects of therapy remain a significant concern. To describe late effects prevalence, severity, and risks after HDC-SCR. Retrospective chart review of relapse-free HRNB survivors ≥1 year after single HDC-SCR between 2000 and 2015 at Fred Hutchinson Cancer Research Center. Sixty-one survivors (30 males) were eligible. Median age (years) at SCR was 3.5 years (range 0.7-27 years) and median posttransplant follow-up was 5.4 years (1.2-16.3 years) . Fifty-three (86.9%) survivors developed late effects that increased over time (P < 0.001) and varied in severity from grade 1 (35) to grade 5 (1). These were unrelated to gender or age. High-frequency hearing loss seen in 82% of survivors was the most common abnormality present and 43% of those required hearing aids. Seventeen (27.9%) survivors developed dental late effects and these were most common in children <2 years of age at transplant (P = 0.008). Other toxicities included endocrine (18%), orthopedic (1...Continue Reading

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Citations

Jan 13, 2019·The Journal of Pharmacology and Experimental Therapeutics·Carlos Rodríguez-NogalesMaría J Blanco-Prieto
Apr 23, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Rebecca FosterNina S Kadan-Lottick
Jun 22, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Alberto GaraventaRuth Lydia Ladenstein

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