Hypertension complicating 131I-meta-iodobenzylguanidine therapy for neuroblastoma

Abstract

Clinically relevant hypertension following (131)I-mIBG therapy affected less than 5% of administrations, but was more common in those patients with preexisting hypertension. As hypertensive episodes may occur many hours after treatment, close monitoring of BP needs to be continued for at least 48 h after administration of (131)I-mIBG.

Toxicity of upfront 131I-metaiodobenzylguanidine (131I-MIBG) therapy in newly diagnosed neuroblastoma patients: a retrospective analysis

“…Kosmin et al found a significant association between adverse events during and 20 to 25 h after 131 I-MIBG infusion and a systolic blood pressure above the 90th centile before 131 I-MIBG infusion. One of the four adverse events they describe was severe with seizures [11]. In the literature only two other cases of PRES have been described in neuroblastoma patients, and none of these patients were treated with 131 I-MIBG [12].…”

Acute changes in blood pressure in patients with neuroblastoma treated with 131 I-metaiodobenzylguanidine (MIBG)

“…Another study reported that the majority of infusions were uncomplicated, with blood pressure changes that were not predictable or clinically relevant. However, this group reported four significant adverse events related to hypertension that occurred during or within 1 day after 131 I‐MIBG administration .…”

Impact of Whole-Body Radiation Dose on Response and Toxicity in Patients With Neuroblastoma After Therapy With131I-Metaiodobenzylguanidine (MIBG)

“…Phase 1 and other pilot studies have shown the primary dose‐limiting toxicity to be myelosuppression, though this toxicity can be alleviated through autologous hematopoietic stem cell support . Possible nonhematological toxicities include transient nausea and vomiting, sialoadenitis, hypertensive episodes, hepatic dysfunction, hypothyroidism, infertility, and secondary cancers …”