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Comparison of pain outcomes between two anti‐GD2 antibodies in patients with neuroblastoma
Author(s) -
Anghelescu Doralina L.,
Goldberg Jacob L.,
Faughnan Lane G.,
Wu Jianrong,
Mao Shenghua,
Furman Wayne L.,
Santana Victor M.,
Navid Fariba
Publication year - 2015
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25280
Subject(s) - medicine , opioid , neuroblastoma , neuropathic pain , morphine , antibody , complement (music) , anesthesia , immunology , receptor , biochemistry , chemistry , complementation , biology , gene , genetics , phenotype , cell culture
Background Addition of anti‐GD2 antibody ch14.18 to the treatment of neuroblastoma has improved outcomes. The most common side effect of ch14.18 is neuropathic pain, which may in part be complement‐mediated. Hu14.18K322A is a humanized anti‐GD2 antibody designed to diminish complement activation and induce less pain. We compare the pain outcomes in patients treated with ch14.18 and those treated with hu14.18K322A, and explore dose‐dependent relationships between pain scores, opioid requirements, and complement levels in patients treated with hu14.18K322A. Procedure Opioid (morphine equivalent mg/kg) and anxiolytic requirements during course 1 (4 days) in patients treated with hu14.18K322A and ch14.18 were reviewed. Correlations between antibody dose and pain scores, opioid requirements, and complement levels were examined for patients receiving hu14.18K322A. Results Patients treated with hu14.18K322A (n = 19) had lower opioid requirements than those who received ch14.18 (n = 9). The differences in median opioid requirements (mg/kg) were statistically significant for the overall course (1.57 vs. 2.41, P = 0.019) as well as for Days 3 (0.34 vs. 0.65, P = 0.005), and 4 (0.32 vs. 0.64, P = 0.010). No difference in anxiolytic use was observed between the two groups. In the group treated with hu14.18K322A, we found a positive correlation between antibody dose administered and pain scores, but no correlation between antibody dose and opioid requirements or changes in complement levels. Conclusions In this retrospective analysis, hu14.18K322A induced less pain than ch14.18 based on opioid requirements. Pediatr Blood Cancer 2015;62:224–228. © 2014 Wiley Periodicals, Inc.