Abstract | BACKGROUND: PROCEDURE: The ch14.18 infusion is administered for ≥ 10 hr over four consecutive days in each of 5 cycles. Hydromorphone (2-8 mcg.kg(-1) .hr(-1) ) and dexmedetomidine (0.1-0.6 mcg.kg(-1) .hr(-1) ) infusions were commenced 1 hr before starting ch14.18 immunotherapy and titrated to optimal clinical effect. One hour after stopping the ch14.18 infusion, dexmedetomidine was discontinued and hydromorphone weaned as tolerated. This strategy was supervised by the Acute Pain Service with strict monitoring and nursing policies. Patient charts were reviewed for evidence of side effects and quality of analgesia. RESULTS: Data from six patients, with median (range) age of 3.5 (2-12) years are reported. Median (range) utilization of hydromorphone was 2.9 (2.0-4.7) mcg.kg(-1) .hr(-1) , and of dexmedetomidine was 0.17 (0.10-0.20) mcg.kg(-1) .hr(-1) . A drop in mean arterial pressure ≥ 30% below baseline was identified during 30% of treatment days, but only prompted interrupting or reducing the ch14.18 infusion on 7% of treatment days; only one episode of grade 3 hypotension was recorded during this series. Hypoxemia occurred during 8% and bradycardia during 4% of treatment days. CONCLUSIONS:
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Authors | Matthias Görges, Nicholas West, Rebecca Deyell, Pamela Winton, Wesley Cheung, Gillian Lauder |
Journal | Pediatric blood & cancer
(Pediatr Blood Cancer)
Vol. 62
Issue 1
Pg. 29-34
(Jan 2015)
ISSN: 1545-5017 [Electronic] United States |
PMID | 25263424
(Publication Type: Journal Article)
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Copyright | © 2014 Wiley Periodicals, Inc. |
Chemical References |
- Analgesics, Non-Narcotic
- Analgesics, Opioid
- Antibodies, Monoclonal
- Gangliosides
- ganglioside, GD2
- Dexmedetomidine
- dinutuximab
- Hydromorphone
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Topics |
- Analgesics, Non-Narcotic
(therapeutic use)
- Analgesics, Opioid
(therapeutic use)
- Antibodies, Monoclonal
(adverse effects)
- Child
- Child, Preschool
- Dexmedetomidine
(therapeutic use)
- Drug Therapy, Combination
- Female
- Follow-Up Studies
- Gangliosides
(immunology)
- Humans
- Hydromorphone
(therapeutic use)
- Immunotherapy
- Male
- Neuroblastoma
(complications, immunology, therapy)
- Pain
(chemically induced, drug therapy)
- Pain Management
- Prognosis
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