JOPHON NCPD (March/April 2026) Dinutuximab-Associated Neurotoxicity: Incidence, Presentation, Risk Factors, and Nursing Interventions-ARTICLE-Dinutuximab-Associated Neurotoxicity: Incidence, Presentation, Risk Factors, and Nursing Interventions

ARTICLE-Dinutuximab-Associated Neurotoxicity: Incidence, Presentation, Risk Factors, and Nursing Interventions

Pdf Summary

This retrospective study examined dinutuximab-associated neurotoxicity in 65 pediatric patients with neuroblastoma across 437 treatment cycles from 2018 to 2023. Neurotoxicity occurred in 159 cycles (36.4%) and affected 54 patients (83.1%). Urinary retention was the most common symptom, followed by visual changes and altered mental status. Symptoms typically began early: nearly three-quarters of affected cycles had onset on the first day. Rare but serious events included seizures and transverse myelitis.<br /><br />The study found no significant association between neurotoxicity and age, sex, treatment phase (upfront versus relapsed/refractory), or Curie score. Nursing and interprofessional responses varied and included administering medications, bladder scans and catheterization, closer neurologic monitoring, pausing or slowing the infusion, specialty consultations, and—in a small number of cases—transfer to higher-level care. Neurotoxicity led to discontinuation of further dinutuximab in four patients.<br /><br />The findings suggest that all patients may be at risk and should receive ongoing, targeted neurologic monitoring, particularly early in each treatment cycle. The authors recommend developing and evaluating standardized, evidence-based screening and management guidelines, along with incorporating anticipatory education for families and staff. Results should be interpreted cautiously because the study was retrospective and conducted at one institution; symptoms could have other causes, and incomplete disease-burden data may have limited assessment of risk factors.

Keywords

dinutuximab

neurotoxicity

pediatric neuroblastoma

retrospective study

urinary retention

visual changes

altered mental status

seizures

neurologic monitoring

standardized guidelines