Acute changes in blood pressure in patients with neuroblastoma treated with <sup>131</sup>
I-metaiodobenzylguanidine (MIBG)

Wong, Teck Huat; Matthay, Katherine K.; Boscardin, W. John; Hawkins, Randall A.; Brakeman, Paul; DuBois, Steven G.

doi:10.1002/pbc.24551

Cited by 16 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of reports describe severe hypertension associated with neuroblastoma. 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 Patients may have transient hypertension, which can be exacerbated by induction of anesthesia or intraoperative tumor manipulation. 6 , 7 , 8 , 9 , 10 , 11 Others may develop refractory hypertension around the time of administration of chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Catecholamines in neuroblastoma: Driver of hypertension, or solely a marker of disease?

2021

View full text Add to dashboard Cite

Background Neuroblastoma is a common solid tumor of childhood and is often associated with hypertension. Potential etiologies contributing to hypertension include renal compression, pain, volume overload, and catecholamine secretion. Cases We completed a single center retrospective review of children with neuroblastoma and ≥stage II hypertension (per Hypertension Canada guidelines) over a 2‐year period. All patients ( n = 10) had elevated urine normetanephrine levels and eight had intra‐abdominal tumors. Four patients had refractory hypertension requiring > three agents, of which three required alpha/beta blockade. Conclusion Although multifactorial, hypertension in neuroblastoma often has a neuroendocrine component. Excess normetanephrine production in neuroblastoma may be a more common hypertensive mechanism than previously appreciated. Urinary normetanephrine elevation could suggest potential neuroendocrine‐mediated hypertension.

show abstract

Section: Introductionmentioning

confidence: 99%

Catecholamines in neuroblastoma: Driver of hypertension, or solely a marker of disease?

2021

View full text Add to dashboard Cite

show abstract

“…High doses of MIBG therapy are preferred in children especially with autologous hematopoietic stem cell support and a dose of 0.67 GBq (18 mCi)/kg is generally accepted as the maximum dose per administration . MIBG therapy is well tolerated; acute adverse events can be easily managed and include mild hypertension, transient sialoadenitis, and nausea . Challenges to the use of high‐dose MIBG therapy in young children with neuroblastoma include limiting radiation exposures to parents, maintaining doses as low as reasonably achievable (ALARA) to medical staff caring for the patient, limiting dose rates in contiguous clinical areas and contamination concerns.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Administering High-Dose¹³¹I-MIBG Therapy to Children with High-Risk Neuroblastoma Without Lead-Lined Rooms

Chu

Horan

Basu

et al. 2016

Pediatr Blood Cancer

View full text Add to dashboard Cite

Background Although 131I-metaiodobenzylguanidine therapy (131I-MIBG) is increasingly used for children with high-risk neuroblastoma, a paucity of lead-lined rooms limits its wider use. We implemented radiation safety procedures to comply with New York City Department of Health and Mental Hygiene regulations for therapeutic radioisotopes and administered 131I-MIBG using rolling lead shields. Procedure Patients received 0.67GBq (18mCi)/kg/dose 131I-MIBG on an IRB-approved protocol (NCT00107289). Radiation safety procedures included private room with installation of rolling lead shields to maintain area dose rates ≤0.02mSv/h outside the room, patient isolation until dose rate <0.07mSv/h at 1m and retention of a urinary catheter with collection of urine in lead boxes. Parents were permitted in the patient’s room behind lead shields, trained in radiation safety principles and given real-time radiation monitors. Results Records on 16 131I-MIBG infusions among 10 patients (age 2–11 years) were reviewed. Mean ± standard deviation 131I-MIBG administered was 17.67±11.14 (range: 6.11–40.59) GBq. Mean maximum dose rates outside treatment rooms were 0.013±0.008 mSv/hr. Median time-to-discharge was 3 days post-131I-MIBG. Exposure of medical staff and parents was below regulatory limits. Cumulative whole-body dose received by the physician, nurse and radiation safety officer during treatment was 0.098±0.058, 0.056±0.045, 0.055±0.050 mSv respectively. Cumulative exposure to parents was 0.978±0.579mSv. Estimated annual radiation exposure for inpatient nurses was 0.096±0.034mSv/nurse. Thyroid bioassay scans on all medical personnel were

show abstract

“…Other commonly observed toxicities are transient thyroid dysfunction, sialoadenitis (100), hepatic transaminitis (101), and mild acute hypertension (102). The incidence of secondary malignancy is similar to that observed in children treated with chemotherapy with a cumulative incidence of 7.6% and 14.3% at 5 and 10 y after therapy, respectively (103).…”

Section: Net Targeting For Therapy 123 I/ 131 I-mibg Theranostics Formentioning

confidence: 57%

Norepinephrine Transporter as a Target for Imaging and Therapy

Pandit‐Taskar

Modak

2017

J Nucl Med

View full text Add to dashboard Cite

The norepinephrine transporter (NET) is essential for norepinephrine uptake at the synaptic terminals and adrenal chromaffin cells. In neuroendocrine tumors, NET can be targeted for imaging as well as therapy. One of the most widely used theranostic agents targeting NET is metaiodobenzylguanidine (MIBG), a guanethidine analog of norepinephrine. 123 I/ 131 I-MIBG theranostics have been applied in the clinical evaluation and management of neuroendocrine tumors, especially in neuroblastoma, paraganglioma, and pheochromocytoma. 123 I-MIBG imaging is a mainstay in the evaluation of neuroblastoma, and 131 I-MIBG has been used for the treatment of relapsed high-risk neuroblastoma for several years, however, the outcome remains suboptimal. 131 I-MIBG has essentially been only palliative in paraganglioma/pheochromocytoma patients. Various techniques of improving therapeutic outcomes, such as dosimetric estimations, high-dose therapies, multiple fractionated administration and combination therapy with radiation sensitizers, chemotherapy, and other radionuclide therapies, are being evaluated. PET tracers targeting NET appear promising and may be more convenient options for the imaging and assessment after treatment. Here, we present an overview of NET as a target for theranostics; review its current role in some neuroendocrine tumors, such as neuroblastoma, paraganglioma/ pheochromocytoma, and carcinoids; and discuss approaches to improving targeting and theranostic outcomes.

show abstract

Acute changes in blood pressure in patients with neuroblastoma treated with ¹³¹ I-metaiodobenzylguanidine (MIBG)

Abstract: Acute elevations in blood pressure are common after therapeutic doses of (131) I-MIBG. Elevations in blood pressure typically occur only within the first 48 hours after (131)I-MIBG administration. Blood pressure monitoring during this period of risk is recommended.

Cited by 16 publications

References 18 publications

Catecholamines in neuroblastoma: Driver of hypertension, or solely a marker of disease?

Catecholamines in neuroblastoma: Driver of hypertension, or solely a marker of disease?

Feasibility of Administering High-Dose¹³¹I-MIBG Therapy to Children with High-Risk Neuroblastoma Without Lead-Lined Rooms

Norepinephrine Transporter as a Target for Imaging and Therapy

Contact Info

Product

Resources

About

Acute changes in blood pressure in patients with neuroblastoma treated with 131 I-metaiodobenzylguanidine (MIBG)

Abstract: Acute elevations in blood pressure are common after therapeutic doses of (131) I-MIBG. Elevations in blood pressure typically occur only within the first 48 hours after (131)I-MIBG administration. Blood pressure monitoring during this period of risk is recommended.

Cited by 16 publications

References 18 publications

Catecholamines in neuroblastoma: Driver of hypertension, or solely a marker of disease?

Catecholamines in neuroblastoma: Driver of hypertension, or solely a marker of disease?

Feasibility of Administering High-Dose131I-MIBG Therapy to Children with High-Risk Neuroblastoma Without Lead-Lined Rooms

Norepinephrine Transporter as a Target for Imaging and Therapy

Contact Info

Product

Resources

About

Acute changes in blood pressure in patients with neuroblastoma treated with ¹³¹ I-metaiodobenzylguanidine (MIBG)

Feasibility of Administering High-Dose¹³¹I-MIBG Therapy to Children with High-Risk Neuroblastoma Without Lead-Lined Rooms