Abstract
Neuroblastoma (NB) is the most common extracranial solid embryonic tumor in children. The age of patient, the prevalence of the tumor process and the molecular genetic profile formed the basis of risk-adapted therapy protocols. High-risk patients receive complex treatment, including various combinations of chemotherapy drugs, surgical removal of the tumor, radiation and radioisotope therapy. Since the end of the 90s of the last century, immunotherapy has been introduced into clinical practice as a post-consolidation phase with the aim of affecting the minimal residual tumour mass. GD2-targeted drugs are used as a therapeutic agent for immunotherapy. An important aspect is the study of the early and late toxicity of this therapeutic method. The main side effects include fever, neuropathic pain, allergic reactions, and capillary leak syndrome. The article presents the analysis of literature data on toxic effects arising from immunotherapy (dinutuximab beta), as well and a description of clinical case report of rare specific pathology – ophthalmic complications, which include mydriasis and accommodation disorder up to paresis. The pathogenesis of these disorders is described in the literature as a parasympathetic deficiency, realized through exposure to anti-GD2 drugs, and is leveled after the end of treatment. Given the reversible nature of the disorders, the occurrence of ophthalmic complications does not require the abolition of immunotherapy, however, careful ophthalmological monitoring of the dynamics of pathological manifestations and timely symptomatic correction of the revealed changes are necessary. This information is very important not only for pediatric oncologists/hematologists, but also for ophthalmologists and pediatricians.
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