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Related Experiment Videos

Chronic neuroblastoma.

Brian H Kushner1, Kim Kramer, Nai-Kong V Cheung

  • 1Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. kushnerb@mskcc.org

Cancer
|September 7, 2002
PubMed
Summary

Childhood metastatic neuroblastoma (NB) can have an indolent course, similar to adults. Advanced therapies, including immunotherapy, can transform NB into a chronic disease with improved survival rates after recurrence.

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Area of Science:

  • Pediatric Oncology
  • Cancer Research
  • Immunotherapy

Background:

  • Neuroblastoma (NB) in adolescents and adults often follows an indolent course.
  • This study investigates indolent NB in a large cohort of children with metastatic disease.

Purpose of the Study:

  • To analyze the phenomenon of indolent neuroblastoma in children with metastatic disease.
  • To evaluate treatment outcomes and survival in this patient group.

Main Methods:

  • Retrospective analysis of 38 children diagnosed with metastatic NB in the first decade of life.
  • Patients had metastatic disease for at least 5 years from diagnosis.
  • Evaluation of treatment strategies including myeloablative therapy, anti-GD2 immunotherapy, cis-retinoic acid, radiotherapy, and chemotherapy.

Main Results:

  • A subset of patients (9/30 with classic Stage 4 NB, 6/8 with atypical NB) experienced late first recurrence (4.3-38.8 years post-diagnosis).
  • Nineteen patients had prolonged periods off therapy before recurrence.
  • Survival was prolonged in 12 patients (median 6y 10m+) with advanced therapies, including 4 complete remissions.
  • 26 patients died of disease or toxicity.

Conclusions:

  • Indolent or smoldering neuroblastoma is not exclusive to adolescents and adults.
  • Modern treatments, including biologic therapies and less toxic chemotherapy, can manage childhood NB as a chronic condition.
  • Prolonged survival is achievable after recurrence with current therapeutic approaches.

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