Which medications are used in the treatment 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 medications may be used:

  • Infection prophylaxis: Chemotherapy agents cause myelosuppression and immunosuppression. All patients should receive prophylaxis against Pneumocystis jiroveci with trimethoprim/sulfamethoxazole (trimethoprim 2.5 mg/kg/dose twice daily), administered on 3 consecutive days per week. Prophylaxis is started before chemotherapy and continued for at least 3 months after completing therapy.

  • Colony-stimulating factors: Granulocyte colony stimulating factor (G-CSF) support has become common in pediatric oncology as intensity of chemotherapy has increased. Treat with 5-10 mcg/kg/d subcutaneously to start 24-36 hours after the last dose of chemotherapy. G-CSF is continued until the absolute neutrophil count is 2,000-10,000. See the Absolute Neutrophil Count calculator.

    A mouse model study by Agarwal et al suggested that G-CSF promotes the growth of neuroblastoma cancer stem cells that may be responsible for cancer relapse. [26, 27]


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