The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

I-131 MIBG Therapy for Pediatric High-Risk Neuroblastoma: Targeted Radiopharmaceutical

Iodine-131 metaiodobenzylguanidine targeted radionuclide therapy for relapsed and refractory high-risk neuroblastoma in children with norepinephrine transporter expressing tumors

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is I-131 MIBG Therapy for Pediatric High-Risk Neuroblastoma: Targeted Radiopharmaceutical?

I-131 MIBG is targeted radiopharmaceutical with norepinephrine analog labeled with iodine-131 beta-emitter for tumor radiation delivery.

Norepinephrine transporter expression on neuroblastoma cells enables selective MIBG uptake supporting both diagnostic imaging and therapeutic targeting.

Diagnostic MIBG scan with I-123 labeled tracer identifies MIBG-avid disease appropriate for therapeutic dosing.

Indication is for relapsed or refractory high-risk neuroblastoma with MIBG-avid disease in pediatric and young adult patients.

Theranostic approach with imaging-guided treatment selection optimizes patient selection and response prediction.

Symptoms

Severe myelosuppression with prolonged thrombocytopenia and neutropenia is dose-limiting toxicity often requiring stem cell support.
Nausea, vomiting and acute radiation syndrome require antiemetic prophylaxis and supportive care during therapy.
Hypothyroidism develops in significant proportion despite thyroid blockade requiring lifelong thyroid hormone replacement.
Secondary malignancy risk including thyroid cancer and myelodysplastic syndrome requires lifetime surveillance.
Radiation safety precautions including isolation and contact restrictions affect family bonding during treatment period.

Risk Factors

Bone marrow involvement reduces eligibility for unsupported therapy requiring autologous stem cell rescue planning.
Prior cumulative radiation exposure including total body irradiation increases secondary malignancy and toxicity risk.
Renal dysfunction may delay MIBG clearance prolonging radiation exposure to non-target organs.
Concomitant medications affecting norepinephrine transporter function reduce tumor MIBG uptake compromising efficacy.
Young age at therapy increases lifetime second cancer risk requiring extended surveillance protocols.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Relapsed or refractory high-risk neuroblastoma after standard induction therapy warrants therapeutic MIBG eligibility evaluation.
  • Diagnostic MIBG scan demonstrating tumor uptake confirms candidacy for I-131 MIBG therapy.
  • Adequate organ function including renal, hepatic and bone marrow reserve required for therapeutic dosing.
  • Specialized pediatric oncology centers with MIBG therapy expertise and radiation safety infrastructure required.
  • Multidisciplinary care including pediatric oncology, nuclear medicine, radiation oncology and supportive care specialists optimizes outcomes.

Treatment Methods

01
I-131 MIBG dosing weight-based with single or fractionated administration in radiation isolation rooms.
02
Thyroid blockade with potassium iodide prophylaxis prevents thyroid uptake reducing thyroid radiation exposure.
03
Autologous stem cell support availability ensures hematopoietic recovery for higher dose treatment regimens.
04
Supportive care including antiemetic prophylaxis, hydration, blood product support, infection prophylaxis manages acute toxicity.
05
Comprehensive long-term surveillance including thyroid function monitoring, second malignancy screening, growth and development assessment, fertility evaluation supports survivorship care for high-risk neuroblastoma patients receiving this targeted radionuclide salvage therapy.

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Hematoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.