What is the role of lab tests in the workup of pediatric neuroblastoma?

Updated: Oct 09, 2017
  • Author: Norman J Lacayo, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

Any child with a presumed diagnosis of neuroblastoma or any other childhood cancer should be referred to a pediatric cancer center for proper care and evaluation. Laboratory studies should include the following:

  • CBC count and differential (Anemia or other cytopenias suggest bone marrow involvement.)

  • Urine collection for catecholamines (VMA/HVA) and UA

    • A single sample or collected urine test for VMA/HVA is highly accurate in CLIA approved laboratories. Centers usually send samples to a specialty laboratory and/or perform a timed collection of urine.

    • A urinary catecholamine level is considered to be elevated if it is 3 standard deviations higher than the age-related reference range levels.

  • Serum creatinine

  • Liver function tests

    • Alanine aminotransferase (ALT)

    • Aspartate aminotransferase (AST)

    • Total bilirubin

    • Alkaline phosphatase

    • Total protein

    • Albumin

    • Prothrombin time (PT)/activated prothrombin time (aPTT)

  • Electrolytes

  • Calcium

  • Magnesium

  • Phosphorus

  • Uric acid

  • Serum lactate dehydrogenase (LDH)

  • Ferritin

  • Thyroid-stimulating hormone (TSH), T4

  • Immunoglobulin (Ig)G levels


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