I-131 MIBG Therapy at American Family Children's Hospital
MIBG Patient Education
View our patient education presentation on MIBG treatment and learn about the resources available:
Lisa Keller, RN, NP is a nurse practioner with American Family Children's Hospital's Pediatric Hematology, Oncology and Bone Marrow Transplant program. Lisa explains the unique treatment called I-131MIBG offered at the hospital.
Neuroblastoma is the fourth most commonly diagnosed childhood cancer in the United States. It is a children's cancer that develops in specific areas of the nervous system and is found primarily in the abdominal and chest area and associated with the adrenal glands.
Treatment for neuroblastoma typically can involve chemotherapy, surgery, radiation and possibly stem cell transplant, depending on the specifics of the child's case.
Although treatment for childhood neuroblastoma has steadily improved over the last two decades the prognosis varies greatly. This outcome depends on the stage at diagnosis, the age of the child at diagnosis, and each child's specific tumor characteristics.
I-131MIBG Treatment for Neuroblastoma
I-131MIBG is a unique treatment that uses an IV dose of radiation, attached to iodine, to target the neuroblastoma cells. This therapy is currently used to treat neuroblastoma that has either relapsed or has not responded to treatment.
There may be additional uses for I -131 MIBG therapy in the future as part of clinical trials in earlier phases of treatment.
In some ways I-131 MIBG treatment is an easy therapy because unlike other types of treatment, it is not painful and usually does not make the child feel sick. The challenges lie in the length of time the child must remain somewhat isolated after the radiation is administered (typically five days), and in the precautions that must be taken when using radioactive materials.
Special MIBG Treatment Room at American Family Children's Hospital
A special room built during the construction of American Family Children's Hospital will allow this to be one of the five hospitals in the country to offer this specialized care.
The room has a floor, walls and doors that are lead lined so that the radiation stays confined to the room. There will also be lead shields in the room to provide additional protection for staff and families who are in the room for support and care during treatment.
A special system will be used to remove radioactive urine from the room. There are additional monitors and a closed circuit television for communication. All of the nursing, medical and additional staff that will treat the children will receive specific training on how to care for children during the MIBG treatment as well as provide for their own safety.
What to Expect During MIBG Treatment
Children are hospitalized for approximately five days, during which time they are emitting radioactivity. The IV infusion of I-131 MIBG lasts about 90 minutes. Following that, children have minimal contact with the staff during the time that it takes for the radiation to be eliminated from their bodies (mostly through the urine). The child is ready for discharge when the amount of radioactivity has dropped to a safe level.
For most families the biggest challenge will be planning how to deal with the child's boredom while sitting in the hospital bed feeling overall pretty energetic. The room has a video game system, a television and plenty of space for all the necessary people and equipment. Families will receive lots of pre-treatment preparation for this task of planning activities for the period of confinement.
Upon discharge there is lingering minimal radioactivity that will require that some safety guidelines be followed. For several weeks after treatment children will be followed carefully with blood counts and scans. Decreasing tumor size can take several weeks to occur. Many children have low blood counts and may require GCSF and transfusions as the radiation affects their bone marrow.