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Respiratory Difficulties in Children With Underlying Asthma During Immunotherapy for High-risk Neuroblastoma

Laura K Metrock1, Muna Qayed, Dawn Simon

  • 1*Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta †Division of Pediatric Pulmonology ∥Division of Radiation Oncology, Emory University, Atlanta, GA ‡Division of Pediatric Allergy, Immunology, and Pulmonology Medicine §Division of Pediatric Hematology/Oncology, Vanderbilt University School of Medicine, and Monroe Carell Jr Children's Hospital, Nashville, TN.

Journal of Pediatric Hematology/Oncology
|January 26, 2017
PubMed

Insights

Antibody-based immunotherapy improves high-risk neuroblastoma survival but causes side effects. Children with asthma need early pulmonology care to manage respiratory risks and complications.

Area of Science:

  • Pediatric Oncology
  • Immunotherapy
  • Pulmonology

Background:

  • High-risk neuroblastoma treatment now standardly includes antibody-based antitumor immunotherapy.
  • This immunotherapy has significantly improved patient survival rates.

Observation:

  • Immunotherapy is associated with considerable side effects.
  • Children with pre-existing respiratory conditions, especially asthma, are at higher risk for immunotherapy-related respiratory compromise and pulmonary issues.

Findings:

  • Patients with asthma may experience exacerbated respiratory complications during immunotherapy.
  • Pulmonary complications can arise from immunotherapy in susceptible pediatric patients.

Implications:

  • Early and routine pulmonology consultation is recommended for neuroblastoma patients with asthma.
  • Involving pulmonologists can optimize immunotherapy delivery and reduce acute and long-term respiratory complications.

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