{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:09:45Z","timestamp":1760148585102,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Neuroblastoma (NB) is a neural crest-derived malignant tumor which is diagnosed during infancy in approximately 40% of cases; spontaneous regressions are observed, but there are varying degrees of severity. Treatment is indicated if an infant\u2019s condition is at risk of deterioration. Herein, we report the case of a 42-day-old boy who presented with hepatomegaly and was diagnosed with stage MS NB. A pathological diagnosis of \u201cpoorly differentiated neuroblastoma with low mitosis-karyorrhexis index, favorable histology\u201d was made; his tumor cells were hyperdiploid and MYCN was not amplified. Because he had respiratory distress caused by the rapidly evolving hepatomegaly, two cycles of chemotherapy containing vincristine and cyclophosphamide were administered in the second and fourth weeks of admission; however, his abdominal tumor did not shrink. In the sixth week of admission, chemotherapy was revised to pirarubicin and cyclophosphamide, and the tumor began to shrink. After discharge, there was no re-elevation of tumor markers; after 1 year, the hepatomegaly and liver metastases disappeared. During the 5-year follow-up, his growth and development were normal and he progressed without sequelae. A regimen that includes pirarubicin could merit further study in the treatment of early infants with stage MS low-risk NB who are at risk of complications.<\/jats:p>","DOI":"10.3390\/children10050871","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T10:49:51Z","timestamp":1683888591000},"page":"871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pirarubicin Combination Low-Dose Chemotherapy for Early Infantile Stage MS Neuroblastoma: Case Report"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-3724","authenticated-orcid":false,"given":"Yutaka","family":"Kato","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima-Shi 734-8551, Hiroshima, Japan"},{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0036-451X","authenticated-orcid":false,"given":"Hiroshi","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima-Shi 734-8551, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Sakata","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"},{"name":"Ueda Child Clinic, 591-6 Tsubakihara, Hashimoto 648-0052, Wakayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munehiro","family":"Okano","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"},{"name":"Department of Pediatrics, Kaizuka City Hospital, 3-10-20 Hori, Kaizuka 597-0015, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuuki","family":"Nishino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"},{"name":"Department of Pediatrics, Sakai Sakibana Hospital, 2-7-1 Harayamadai, Minami-ku, Sakai 590-0132, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masako","family":"Ryujin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Takemura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsukasa","family":"Takemura","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"},{"name":"Department of Pediatrics, Kushimoto Municipality Hospital, 691-7, Sangodai, Kushimoto, Higashimuro 649-3510, Wakayama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Kindai University, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima-Shi 734-8551, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6459","DOI":"10.1200\/JCO.2005.05.571","article-title":"Evidence for an age cutoff greater than 365 days for neuroblastoma risk group stratification in the Children\u2019s Oncology Group","volume":"23","author":"London","year":"2005","journal-title":"J. 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