The use of pharmacokinetically guided carboplatin chemotherapy in a pre-term infant with neuroblastoma-associated spinal cord compression

Pediatr Blood Cancer. 2019 Sep;66(9):e27825. doi: 10.1002/pbc.27825. Epub 2019 May 28.

Abstract

Neonatal neuroblastoma may require chemotherapy either due to mass effect or unfavourable cytogenetics. This case focuses on using pharmacokinetic (PK) guided chemotherapy to treat neonatal neuroblastoma. A newborn baby was noted to have left leg immobility. Imaging showed a retroperitoneal tumour with spinal canal extension causing spinal cord compression. PK-guided carboplatin was given after conventionally dosed chemotherapy demonstrated no improvement. After initiation of PK therapy, clinical and radiological improvement was seen. We discuss our decision to use PK-guided chemotherapy despite guidelines recommending weight-based dosing and discuss the benefits in terms of clinical efficacy without increased toxicity.

Keywords: carboplatin; neonatal; neuroblastoma; pharmacokinetic.

Publication types

  • Case Reports

MeSH terms

  • Carboplatin* / administration & dosage
  • Carboplatin* / pharmacokinetics
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Neuroblastoma* / diagnostic imaging
  • Neuroblastoma* / drug therapy
  • Neuroblastoma* / metabolism
  • Retroperitoneal Neoplasms* / diagnostic imaging
  • Retroperitoneal Neoplasms* / drug therapy
  • Retroperitoneal Neoplasms* / metabolism
  • Spinal Cord Compression* / diagnostic imaging
  • Spinal Cord Compression* / drug therapy
  • Spinal Cord Compression* / metabolism

Substances

  • Carboplatin