Neuroblastoma Program

Although neuroblastoma is a rare disease, it is also the third most common pediatric cancer and the second most common type of solid tumor in children. Neuroblastoma is usually diagnosed in children under age 5.

What is neuroblastoma?

This cancer develops in nerve cells called neuroblasts that make up the tissues in the sympathetic nervous system. The sympathetic nervous system controls functions such as breathing, heart rate, digestion and blood pressure.

Neuroblasts usually mature to form nerve tissue during fetal development. When neuroblasts don’t form properly in the womb, neuroblastoma can develop. This is why neuroblastoma almost always affects children.

Neuroblastoma often starts in the adrenal glands but can develop anywhere in the sympathetic nervous system and can spread elsewhere in the body.

How We Can Help

If your child has been diagnosed with neuroblastoma, you might feel scared and overwhelmed. At Children’s Hospital Los Angeles, our physicians specialize in treating neuroblastoma in children. Doctors collaborate with researchers to pioneer new treatments and provide the most advanced treatment options. Our goal is to improve quality of life and increase successful outcomes for all of our neuroblastoma patients.

Neuroblastoma Stages

Your child’s treatment options will depend in part on the tumor’s classification. Like other types of cancer, neuroblastoma is graded from stage 1 to stage 4, depending on whether it has spread.

When neuroblastoma is diagnosed at an earlier stage—or before a child turns 1—there’s a high chance for a successful outcome. And thanks to new research, our team is constantly improving outcomes for more advanced tumors, too.

The stages of neuroblastoma are:

• Stage 1: The tumor has not spread beyond one area of the body and can be removed completely with surgery.
• Stage 2: In stage 2A, surgeons cannot remove the tumor entirely due to its location or size, but there is no cancer in the lymph nodes. In stage 2B, surgeons may be able to remove the tumor completely, but it has spread into the lymph nodes.
• Stage 3: The tumor can’t be removed completely with surgery, and tumors either exist on both sides of the spine, or tumors exist on one side of the spine and in the lymph nodes on the other side of the spine.
• Stage 4: The cancer has spread to other areas of the body.

Innovative Neuroblastoma Treatments

The Neuroblastoma Program at Children’s Hospital Los Angeles has pioneered several new therapies to treat advanced neuroblastoma. Our techniques greatly improve outcomes for children with these tumors. These innovative treatments include:

• CEM regimen: During this process, we use high-dose chemotherapy to destroy cancer cells, and then we transplant healthy donated stem cells. We follow up with oral retinoid treatment. Retinoids are similar to vitamin A and can help prevent cancer from recurring. 
• NB5 assay: This new test can detect cancer cells left in the body after treatment that a standard screening may miss. Having more accurate information will help us recommend the right treatment to avoid recurrence.
• Immunotherapy: We’re developing treatment using a patient’s own natural killer (NK) cells, a type of white blood cell that can attack tumor cells.

Clinical Trials

Neuroblastoma Program physicians are members of the Children’s Oncology Group (COG) Neuroblastoma committee. This collaboration helps us stay active in research and clinical trials of new therapies.

We are also part of the New Approaches to Neuroblastoma Therapy (NANT) Consortium, a group of 14 pediatric cancer centers with expertise in neuroblastoma. NANT works to find new options for neuroblastoma patients who have not responded successfully to standard treatment.

Find out more about our current clinical trials