Outcome of Premature Infants Treated With Chemotherapy for Neuroblastoma in France

Neuroblastoma is the most common extracranial solid tumor in children, and congenital forms account for 5% of all neuroblastoma cases. In utero diagnosis is very rare, and the progression leading to premature delivery for urgent treatment is exceptional. In some of these cases, chemotherapy is required after birth, given tumor progression that threatens the functional prognosis (dumbbell neuroblastoma), or even survival (Stage MS). However, the optimal doses of chemotherapy in premature newborns are not known. We present a retrospective cohort of six patients treated in French pediatric oncology centers in order to analyze treatment modalities, and report on their tolerance (five Grade 4 hematological toxicity, three septicemias) as well as the outcome of these newborns (two deaths, four remissions).