Neuroblastoma High-Dose Chemotherapy/Radiation Therapy

This type of treatment is used in children with high-risk neuroblastoma who are unlikely to be cured with other treatments. It involves giving high doses of chemotherapy (higher than could safely given otherwise) and/or radiation therapy (total body irradiation or high-dose MIBG), and then replacing the body’s bone marrow cells, which were killed by the treatment. In the past, this type of treatment was commonly referred to as a bone marrow transplant.

The bone marrow is the soft, inner part of some bones where new red blood cells, white blood cells, and platelets are formed. Red blood cells carry oxygen to all parts of the body. White blood cells are part of the immune system, which fights off infections. Platelets are needed to stop bleeding caused by cuts and scrapes.


Both chemotherapy and some types of radiation can affect blood-forming stem cells in the bone marrow. (These are the cells that make the different types of blood cells.) Even though more intensive treatments might be more effective in treating tumors, they can’t be given because they would cause severe damage to the bone marrow, leading to life-threatening shortages of blood cells.


The most recent and exciting advancements in cancer treatment involve the use of Immunotherapies. Monoclonal antibodies are man-made versions of immune system proteins that can be programmed to attack a very specific target. These molecules can be injected into the body to seek out and attach to cancer cells. A monoclonal antibody called ch14.18 has been developed to attach to the ganglioside GD2, a substance found on the surface of many neuroblastoma cells. This antibody is often given together with cytokines (immune system hormones) such as GM-CSF and interleukin-2. This combination can help the child's immune system to recognize and destroy neuroblastoma cells.
This antibody is now part of the routine treatment for many children with high-risk neuroblastoma.

Possible Side effects
Side effects from immunotherapy may include pain, buildup of fluid in the body and allergic reactions.


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