{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:26:11Z","timestamp":1780529171138,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,8,27]],"date-time":"2018-08-27T00:00:00Z","timestamp":1535328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current treatment strategies have improved the outcome of high\u2010risk neuroblastoma (HRNB) at the cost of increasing acute and late effects of treatment. Although high\u2010dose chemotherapy with stem cell rescue (HDC\u2010SCR) has replaced total body irradiation (TBI) based HRNB therapy, late effects of therapy remain a significant concern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe late effects prevalence, severity, and risks after HDC\u2010SCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective chart review of relapse\u2010free HRNB survivors \u22651 year after single HDC\u2010SCR between 2000 and 2015 at Fred Hutchinson Cancer Research Center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010one survivors (30 males) were eligible. Median age (years) at SCR was 3.5 years (range 0.7\u201027 years) and median posttransplant follow\u2010up was 5.4 years (1.2\u201016.3 years) . Fifty\u2010three (86.9%) survivors developed late effects that increased over time (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and varied in severity from grade 1 (35) to grade 5 (1). These were unrelated to gender or age. High\u2010frequency hearing loss seen in 82% of survivors was the most common abnormality present and 43% of those required hearing aids. Seventeen (27.9%) survivors developed dental late effects and these were most common in children\u00a0&lt;2 years of age at transplant (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). Other toxicities included endocrine (18%), orthopedic (14.8 %), renal (3.9%), melanotic nevi (8.2%), neuropsychological impairments (8.2%), subsequent malignancies (4.9%), pulmonary (4.9%), cardiac (4.9%), and focal nodular liver hyperplasia (3.3%). At 9 years posttransplant, the median height and weight <jats:italic>Z<\/jats:italic>\u2010scores were significantly lower than <jats:italic>Z<\/jats:italic>\u2010scores at the time of HDC\u2010SCR (\u20130.01\/\u20131.08, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; \u20130.14\/\u20130.78, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Avoidance of TBI does not mitigate the need to provide diligent, ongoing surveillance for late effects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27421","type":"journal-article","created":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T15:44:52Z","timestamp":1535557492000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Late effects in high\u2010risk neuroblastoma survivors treated with high\u2010dose chemotherapy and stem cell rescue"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1067-7520","authenticated-orcid":false,"given":"Mahmoud M.","family":"Elzembely","sequence":"first","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Pediatric Oncology Department South Egypt Cancer Institute, Assiut University  Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann E.","family":"Dahlberg","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8775-6710","authenticated-orcid":false,"given":"Navin","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasey J.","family":"Leger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie R.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Scott","family":"Baker","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"},{"name":"Department of Pediatrics University of Washington, Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,27]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"United States Cancer Statistics: 1999\u20132013 Incidence and mortality web\u2010based report","author":"U.S. Cancer Statistics Working Group","year":"2016"},{"key":"e_1_2_7_3_1","first-page":"509","volume-title":"Nathan and Oski's Hematology of Infancy and Childhood E\u2010Book","author":"Shusterman S","year":"2008"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.14694\/EDBK_159169"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910143411601"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70309-7"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.11.022"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21683"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705809"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp230"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.6876"},{"issue":"246","key":"e_1_2_7_12_1","first-page":"1","article-title":"2000 CDC growth charts for the United States: methods and development","author":"Kuczmarski RJ","year":"2002","journal-title":"Vital Health Stat."},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.24.4228"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.34.3293"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60983-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0911123"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910143411601"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-16-0812"},{"key":"e_1_2_7_19_1","volume-title":"Common terminology criteria for adverse events (CTCAE) version 4.03. 2010","author":"US Department of Health and Human Services","year":"2016"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.11.032"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.86"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.COT.0000265629.30194.8e"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2013.218"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2011.29.15_suppl.9515"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.22578"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20036"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24842"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702021"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22839"},{"key":"e_1_2_7_30_1","first-page":"743","article-title":"Drug\u2010induced nephrotoxicity","volume":"78","author":"Naughton CA","year":"2008","journal-title":"Am Fam Physician"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.27421","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.27421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T16:38:52Z","timestamp":1694709532000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.27421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,27]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1002\/pbc.27421"],"URL":"https:\/\/doi.org\/10.1002\/pbc.27421","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,27]]},"assertion":[{"value":"2018-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e27421"}}