Results from a recent paper, the prognosis of stage T1 or T2 neuroblastoma patients depended significantly on non-high-risk/intermediate risk. However, neuroblastoma could often be cured with high-risk/high MYCN-intratumoral heterogeneity without surgery, which may contribute to better survival.
To our knowledge, these data indicate the first evidence of a significant increased risk of neuroblastoma in the brothers of a carrier of a germline RET mutation.
All patients with NB should be tested for MYCN amplification or Ki67 index. The most specific finding is Ki67 index>or = 15%. The presence or absence of MYCN amplification is not very useful in patients less than four years old.
There are no reliable statistics about neuroblastoma diagnoses in the USA. The average number of new annual cases of neuroblastoma in the US is between 10 and 12 cases. Further analysis is needed to determine the number of new cases per year.
Neuroblastoma is an cancer that begins in any part of the nervous system, and accounts for 10-15% of childhood cancers in the United States. The disease tends to present as a slow-growing mass that can be benign, mildly curable, or rapidly fatal. Neuroblastoma is more likely to occur from December to June. The treatment and survival of patients remain limited: two thirds will be lost to treatment or disease progression, and 5% have a 5-year survival rate of 4%.
The risk of dying from the neuroblastoma is one of the highest. It is unclear whether surgery is helpful because the tumor does need to be removed to get a complete analysis of the problem. Children are prone to developing leukemia. Most of these children and their parents suffer a tremendous amount before the cancer is diagnosed. Neuroblastoma is often identified very late. Chemotherapy is not curative and the odds of cure are low. It is a disease which is notoriously difficult to cure.
There is a significant and growing interest in neuroblastoma clinical trials. The study result should be validated and its use should be integrated into neuroblastoma multimodality therapy.
The survival rate increases with the age at diagnosis, the stage of disease, the tumor size, the site of tumor involvement, the presence of metastasis, the amount of tumor involvement in the liver and bone marrow, the presence of tumor-induced hypertension, the presence of neuropathy or encephalopathy, the presence of hypercalcemic hypophosphatemia, and the chemotherapy. Although in most cases the prognosis is favorable, children with very high-risk disease have worse outcomes; therefore, a careful assessment of the patient's prognosis is important prior to treatment.
For treatment patients will have to continue on many drugs for a number of years unless they receive a stem cell transplant. The research isn't showing a cure will emerge for these children. The most recent drugs are chemotherapy or other medical drugs. Chemotherapy is less effective over and over and some children with neuroblastoma are taking them continuously. For the chemotherapy that do come to remission most of the body's immune systems are damaged and the brain stem is injured and can't function with the body. A stem cell transplant has been developed but it isn't proven whether it will work for all children who need it. The stem cells used are the patient's own. If the tumor cannot be completely removed the new cancer cells will be in the body.
At the 5-month point in our study, (124)I-anti-GD2 immunotox plus autologous stem cell transplantation significantly was associated with significant improvement in HRQL compared with chemotherapy with GM2 monoclonal antibody and autologous stem cell transplantation alone in adults with high-risk neuroblastoma.
Findings from a recent study suggest there is a strong association between age and stage at diagnosis of neuroblastoma patients, with the highest incidence of advanced disease recorded among infants and toddlers. The effect of age on treatment outcome warrants further investigation.
hu3f8 is an avid and reliable antibody, but only a small portion (40%) of pediatric NB patients could be treated with it; more studies are needed to confirm this finding.