{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:10:19Z","timestamp":1790244619508,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>In patients affected by high\u2010risk neuroblastoma (HR\u2010NB), complete macroscopic resection (CMR) is associated with better outcomes. These patients are often cytopenic due to intensive induction regimens. The aim of the present study is to assess the impact of preoperative cytopenia on surgical outcome in patients with HR\u2010NB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A chart review of patients with HR\u2010NB operated on after neoadjuvant chemotherapy between January 2013 and July 2024 was conducted. Cytopenia was defined by full blood count values in the 24\u00a0h before surgery. Two primary outcomes were analyzed: the rate of CMR and the incidence of postoperative complications. Secondary outcomes were postoperative\n                      <jats:italic>length of stay<\/jats:italic>\n                      (LOS) and\n                      <jats:italic>red blood cell<\/jats:italic>\n                      transfusion requirement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010eight patients underwent surgical removal of the primary tumor after induction chemotherapy. Thirty\u2010seven patients (54%) were cytopenic immediately before surgery; 17 patients had anemia (25%), 20 had thrombocytopenia (29%; 16 patients with platelets between 100\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L and 50\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L, four patients with platelets less than 50\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L), and six had neutropenia (9%). Patients with platelets less than 50\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L had a significantly higher postoperative complications rate (75% vs. 22%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.046) and increased median LOS [12.5\u00a0days (7\u201331) vs. 7\u00a0days (3\u201343),\n                      <jats:italic>p<\/jats:italic>\n                      = 0.040], but comparable CMR rate and perioperative RBC transfusion volumes. Anemia, neutropenia, and platelets between 100\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L and 50\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L had no impact on outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Anemia, neutropenia, and platelets between 100\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L and 50\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L are not contraindications to elective major surgery in patients with HR\u2010NB. The risk of surgical complications in patients with platelets less than 50\u00a0\u00d7\u00a010\n                      <jats:sup>3<\/jats:sup>\n                      \/\u00b5L has to be balanced against the risk of long delay in surgical treatment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70071","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T07:04:03Z","timestamp":1766473443000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Cytopenia in Patients Affected by High\u2010Risk Neuroblastoma: Just a Matter of Platelets?"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-2726","authenticated-orcid":false,"given":"Giorgio","family":"Persano","sequence":"first","affiliation":[{"name":"Surgical Oncology Unit Bambino Ges\u00f9 Children's Hospital, IRCCS  Rome 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