Long-term outcomes in children with high-risk neuroblastoma treated with autologous stem cell transplantation

Late effects in children treated with intensive multimodal therapy for high-risk neuroblastoma: High incidence of endocrine and growth problems

“…As weight Z-score is often maintained with GHD, it suggests that other mechanisms besides GHD may be affecting their height. Lack of true GHD is consistent with the findings of Trahair et al 12 who noted only 1/13 HR NBL patients with growth failure who had received TBI for SCT had GHD. On the other hand, Perwein et al 13 diagnosed GHD in 6 of 16 HR NBL survivors (37.5%), 13 of whom had received transplant but only 1 of whom had received TBI.…”

Overview and recent advances in the treatment of neuroblastoma

“…Platinum agents are also responsible for the approximately 10-40% of survivors that experience long-term renal toxicities including tubular dysfunction, hypertension, proteinuria/ hematuria, and chronic renal failure [165,166]. Survivors of high-risk neuroblastoma treatment also have a relative risk as high as 16.2 for developing cataracts, including a 13.6-fold increase in the risk of blindness if cranial radiation was a component of therapy [167].…”

Neuroblastoma, childhood cancer survivorship, and reducing the consequences of cure

“…[5][6][7] Such survivorship research in the pediatric setting has focused primarily on the more common malignancies, such as acute lymphoblastic leukemia and Hodgkin's lymphoma, with very little systematic study on late effects of neuroblastoma, perhaps with the exception of documenting the permanent ototoxic effects of cisplatin and carboplatin. [8][9][10][11][12] From the present study 4 and similar clinical followup work by Laverdie`re et al 13 and others, 14 we can reach a brief understanding of the risks for multi-organ sequelae among survivors of advanced stage neuroblastoma. The most prominent are endocrine impairments, including short stature, hypothyroidism and ovarian and testicular dysfunction; musculoskeletal complications, including kyphosis and scoliosis, significant dental abnormalities, slipped capital femoral epiphysis, fractures, fibrosis and hypoplasia; major organ system impairment, most notably serious renal dysfunction, but also cardiac toxicity and lung fibrosis or other pulmonary problems; neurological disorders, including opsoclonus myoclonus (opsoclonus ataxia), neurogenic bladder, and paresis and paraplegia; and sensory impairments, including chronic pain, parasthesia, cataracts and neurosensory hearing loss.…”

“…1 Unfortunately, skirting this trend, highrisk neuroblastoma tumors have proven to be quite obstinate in the face of modern therapy and, even today, children with this form of cancer do not generally fare well. 2,3 As evidenced by the case series presented by Trahair et al, 4 in this issue of Bone Marrow Transplantation, those who are fortunate enough to survive their disease confront many serious long-term adverse effects from neuroblastoma and its treatment.…”