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Immunotherapy in a backpack

Most of the approximately 30 children diagnosed with neuroblastoma each year can now receive immunotherapy at home. Thanks to a new treatment protocol at the Princess Máxima Center for pediatric oncology, fewer side effects occur with the drug dinutuximab and the child has to go to the center in Utrecht less often for admission. The medicine pump fits in a backpack so that the child  is free to move and can, for example, just go to school.

In anticipation of the new European high-risk neuroblastoma protocol (HR NBL2), which started in March 2021 at the Princess Máxima Center, immunotherapy with the drug dinutuximab has been administered months earlier according to the new protocol. The new way of administering dinutuximab in children, much slower, has a lot of influence on the side effects, but not on the effect.

The pump with immunotherapy comes with a backpack so that the child has a lot of freedom of movement. Many children then choose their own model and color backpack and continue to walk, cycle and play with the pump. Parents and children are happy with the new treatment method for neuroblastoma. A mother says: ‘A few years ago, children had to go to America for this treatment! We live an hour and a half's drive from the Máxima Center, so we came to Utrecht for a day to connect and change the cassette. Our daughter felt good and went to school every day with her practical backpack.’

Pump with cassettes
The dinutuximab was previously administered over five days for eight hours a day and is now administered over ten days, with an intravenous drip running 24 hours a day. Five courses are given at three-week intervals. The Máxima pharmacy makes it possible for children to go home after a preparatory treatment in the Máxima Center, with a pump including medicine cassettes. Halfway through the treatment, children come to the Máxima Center on an outpatient basis for a change of the medicine cassette. At the end of the course, home care workers turn off the pump at the child's home.