Late Effects in Pediatric High-risk Neuroblastoma Survivors after Intensive Induction Chemotherapy Followed by Myeloablative Consolidation Chemotherapy and Triple Autologous Stem Cell Transplants

Amy E. Armstrong, Karina Danner-Koptik, Shannon Golden, Jennifer Schneiderman, Morris Kletzel, Jennifer Reichek, Yasmin Gosiengfiao*

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Summary: Multimodal treatment in high-risk neuroblastoma has modestly improved survival; limited data exist on the late effects from these regimens. We report the sequelae of treatment incorporating 3 consecutive cycles of high-dose therapy and autologous stem cell transplants (ASCTs) without the use of total body irradiation (TBI). We reviewed the medical records of 61 patients treated on or following the Chicago Pilot 2 protocol between 1991 and 2008. Of the 25 patients who are alive (41%), 19 had near complete data to report. Specific treatment modalities and therapyrelated side effects were collected. Fourteen of these 19 patients (74%) received 3 cycles of high-dose therapy with ASCT; follow-up occurred over a median of 13.9 years (range, 5.8 to 18.8 y). The majority of late effects were endocrine-related, including growth failure, hypothyroidism, and hypogonadism. Patients also developed secondary neoplasms and skeletal deformities. The most frequent sequela was hearing loss, seen in 17/19 patients. We found a high prevalence of various late effects in survivors of high-risk neuroblastoma using a non-TBI-based regimen including 3 cycles of high-dose therapy with ASCTs. As current treatment regimens recommend tandem ASCT without TBI, it is imperative that we understand and monitor for the sequelae from these modalities.

Original languageEnglish (US)
Pages (from-to)31-35
Number of pages5
JournalJournal of pediatric hematology/oncology
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • Endocrine deficits
  • Hearing deficits
  • High-risk neuroblastoma
  • Late effects
  • Tandem transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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