What is included in the long-term monitoring 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

The following are aspects of further outpatient care in patients with neuroblastoma:

  • Patients are periodically monitored in the clinic after each course of therapy to monitor for complications and to assess response to therapy with diagnostic imaging. Myelosuppression and pancytopenia are common complications, and a CBC count with platelet count is obtained as often as twice per week. Some drugs (eg, cisplatin, carboplatin, ifosfamide) affect renal function; thus, close monitoring of electrolytes is required, with oral electrolyte supplementation when necessary. Blood product support is provided when the hemoglobin drops to less than 8 g/dL, the platelet count drops to less than 10,000, or any signs of bleeding are present.

  • After completion of therapy, successfully treated patients require follow-up care and close surveillance for any signs or symptoms of recurrent disease. Follow-up care includes monitoring of urinary catecholamines, physical examination, and diagnostic imaging. Because most recurrences occur during the first 2 years following treatment, most protocols recommend close follow-up care during this interval.

  • Patients who remain free of recurrent disease for 5 years are considered cured, although rare late relapses have been reported. Long-term follow-up care to assess impact of therapy on growth, development, and organ toxicity is essential.


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