Has my daughter got favourable or unfavourable histology?
 

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04-12-09 06:35 AM
karine
Has my daughter got favourable or unfavourable histology?
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Hi

My 15 month old daughter has been diagnosed with stage iv neuroblastoma with spread to the bone marrow.  All I know is that she has poorly differentiated neuroblastoma.  On looking at the parents book online its puts my daughter as favourable histology as she is under 18 months. Am I to assume that is the case for my daughter.  In the UK our doctors are very different and we don't get to know all the ins and outs regarding histology.  I will speak to my doctor this week but I am very confused at the moment.  What is good or bad histology? What factors make a bad histology or good? I would be grateful for any reply.

Thanks

Mum to Sophie Atay, Stage IV Neuroblastoma MYCN NA

04-12-09 07:47 AM
Donna Ludwinski
Re: Has my daughter got favourable or unfavourable histology?
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 Hi Karine

You caught something important (error) in the pathology section of the handbook.

If you go to the pathology article

http://www.nbhope.org/blogs/parents_handbook/archive/2008/07/02/51865.aspx

and click on the THIRD reference at the end of the article, it links to the full text pathology journal article.

Go to page 2280 and at the top of that page you will see a pathology chart.

The top half of the chart shows ganglioneuroblastoma and the bottom half shows neuroblastoma.

If you look closely at this chart you'll see where the error in the handbook article stems from.

It divides NB into undifferentiated, poorly differentiated, and differentiating--and at the right side you can see which are favorable and unfavorable.

All are unfavorable except for poorly differentiated and differentiated with MKI under 4% and under 1.5 years; and differentiating with MKI under 2% MKI and between 1.5 and 5 years old.

All undifferentiated are unfavorable for all MKI and all ages.

So you need to know her MKI and you still need to know DNA ploidy to be sure of her risk assignment.

Hope this helps!

04-12-09 01:32 PM
karine
Re: Has my daughter got favourable or unfavourable histology?
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Hi Donna

Thanks so much, I understand that now.  I will see the Doctor on Tuesday as Sophie has her 6th round of chemotherapy and will ask her.  I suspect she does have a high MKI as she is "high risk" but it will be interesting to know.  Fingers crossed for her DNA ploidy.

Karine