Xinyi is a five year old girl from China diagnosed with Stage 4 high risk neuroblastoma in June 2015 in China.
She started 3 cycles of chemo.First & second cycles: Vincristine, Cyclophosphamide,pirarubicin respectively. Third cycle: Etoposide, Cisplatin,
Then we came to Singapore for surgical excision of the mass. Histopathology confirmed undifferentiated neuroblastoma, genetics negative for Nmyc amplification, 1p deletion, 11 q deletion. Bone marrow aspiration was negative for disease.
She received two more cycles of chemotherapy. Vincristine, Cyclophosphamide,pirarubicin and Etoposide, Cisplatin.
This was followed by consolidation high dose therapy with busulfan and melphalan, followed by autologous stem cell infusion on 16 November 2015.
Three months later, 10 times radiation was done on the tumor part.
Approximately 140 days from transplant she started immunotherapy with Dinutiximab beta (European medicine, 10 days infusion, without IL2 and GCSF). After the fourth cycle, MIBG scan showed multiple areas of uptake of the bones.
With this, Xinyi started chemotherapy with Topotecan and Cyclophosphamide on September 7 2016 with three cycles. The fourth and fifth cycle of chemotherapy with irinotecan and temozomide. Response has been decrease in bone pain and in the urinary catecholamine levels.
Bone marrow result: No tumor was found in the bone marrow. Right and Left Sections show bone marrows with approximately 50% cellularities.
After relapse, it usually takes 6 or 7 weeks for her blood count recover after each cycle of chemo. Platelets is usually around 50 (reference interval 200-490) at most.
17 March 2017, MIBG scan showed the uptake parts almost the same with last time which did on 26 August 2016.
I am seeking suggestions and advice on treatment methods for my little girl. Even though we know the possibility for fully cure is very slim, we still hope miracle happen on her and she may stay with us longer. Million thanks for your help.