Tandem high-dose 131I-MIBG therapy supported by dosimetry in pediatric patients with relapsed-refractory high-risk neuroblastoma: the Bambino Gesu' Children's Hospital experience

• Published in: Nuclear medicine communications Vol. 43; no. 2; p. 129
• Main Authors: Altini, Claudio, Villani, Maria F, Di Giannatale, Angela, Cassano, Bartolomeo, Pizzoferro, Milena, Serra, Annalisa, Castellano, Aurora, Cannatà, Vittorio, Garganese, Maria C
• Format: Journal Article
• Language: English
• Published: England 01.02.2022
• Subjects: 3-Iodobenzylguanidine - therapeutic use; Adolescent; Child; Child, Preschool; Female; Humans; Iodine Radioisotopes - therapeutic use; Male; Neuroblastoma - radiotherapy; Radiometry; Radiotherapy Dosage; Recurrence; Treatment Outcome
• ISSN: 1473-5628
• DOI: 10.1097/MNM.0000000000001496

131I-meta-iodobenzylguanidine (131I-MIBG) combined with myeloablative chemotherapy represents an effective treatment in children affected by relapsed/refractory neuroblastoma (NBL) for disease palliation and in improving progression-free survival. The aim of our study is to evaluate the feasibility, safety and efficacy of tandem 131I-MIBG followed by high-dose chemotherapy with Melphalan. Thirteen patients (age range: 3-17 years) affected by relapsed/refractory NB, previously treated according to standard procedures, were included in the study. Each treatment cycle included two administrations of 131I-MIBG (with a dosimetric approach) followed by a single dose of Melphalan with peripheral blood stem cell rescue. At the end of the treatment, ten patients experienced grade 4 neutropenia, two grade 3 and one patient grade 2, three patients presented febrile neutropenia and all needed RBC and platelets transfusions; one patient presented grade 4 mucositis, four grade 3 and one patient grade 2 mucositis. One patient showed progressive disease, eight patients showed stable disease and four patients showed partial response. High-dose 131I-MIBG therapy combined with chemotherapy represent a well-tolerated and effective modality of treatment in heavily pretreated patients affected by relapsed/refractory NBL. However, further studies, including a wider cohort of patients, are needed.