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A Retrospective Investigation of the Relationship between Neuroblastoma Response to Cancer Therapy and Exposure to Opioids for Pain Management
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  • Kyle Morgan,
  • Andrew Dudas,
  • Wayne Furman,
  • Beth McCarville,
  • Barry Shulkin,
  • Zhaohua Lu,
  • Himani Darji,
  • Doralina Anghelescu
Kyle Morgan
The University of Tennessee Health Science Center

Corresponding Author:morgankj@gmail.com

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Andrew Dudas
St Jude Children's Research Hospital
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Wayne Furman
St Jude Childrens Research Hospital
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Beth McCarville
St. Jude Chilren's Research Hospital
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Barry Shulkin
St. Jude Children's Research Hospital
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Zhaohua Lu
St Jude Children's Research Hospital
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Himani Darji
St Jude Children's Research Hospital
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Doralina Anghelescu
St. jude Children's Research Hospital
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Abstract

ABSTRACT Objective: Recent increased awareness and research studies reflect possible associations between opioid exposure and cancer outcomes. Children with neuroblastoma (NB) often require opioid treatment for pain. However, associations between tumor response to chemotherapy and opioid exposure have not been investigated in clinical settings. Methods: This is a single institution retrospective review of patients with NB treated between 2013 and 2016. We evaluated opioid consumption quantified in morphine equivalent doses (mg/kg) based on nurse- or patient-controlled analgesia during antibody infusions. We also analyzed their associations with change in tumor volume and extra-adrenal tumor burden. Results: Of 42 patients given opioids for pain related to anti-GD2 mAb, data completion was achieved for 36 and details of statistical analyses were entered. Median total weight-based morphine equivalent (over 8 days) was 4.71 mg/kg (interquartile range 3.49-7.96). We found a statistically insignificant weak negative relationship between total weight-based morphine equivalents and tumor volume ratio (correlation coefficient -0.0103, p-value 0.9525) and a statistically insignificant weak positive relationship between total weight-based morphine equivalent and Curie score (correlation coefficient 0.1096, p-value 0.5247). Conclusion: Our study found no statistically significant correlation between opioid consumption and NK cell-mediated killing of NB cells as measured by effects on tumor volume/tumor load.
11 May 2022Submission Checks Completed
11 May 2022Assigned to Editor
11 May 2022Submitted to Pediatric Blood & Cancer
14 May 2022Reviewer(s) Assigned
12 Jun 2022Review(s) Completed, Editorial Evaluation Pending
20 Jun 2022Editorial Decision: Revise Major
09 Aug 2022Submission Checks Completed
09 Aug 2022Assigned to Editor
09 Aug 20221st Revision Received
09 Aug 2022Reviewer(s) Assigned
07 Sep 2022Review(s) Completed, Editorial Evaluation Pending
14 Sep 2022Editorial Decision: Revise Minor
16 Sep 2022Submission Checks Completed
16 Sep 2022Assigned to Editor
16 Sep 20222nd Revision Received
20 Sep 2022Reviewer(s) Assigned
24 Sep 2022Review(s) Completed, Editorial Evaluation Pending
29 Sep 2022Editorial Decision: Revise Minor
30 Sep 2022Submission Checks Completed
30 Sep 2022Assigned to Editor
30 Sep 20223rd Revision Received
01 Oct 2022Review(s) Completed, Editorial Evaluation Pending
03 Oct 2022Editorial Decision: Accept