Neuroblastoma and Vitamin B12 Therapy | Spontaneous Remission Database

Abstract

An annual survey of an investigation into the response of neuroblastoma to massive Vitamin B12 therapy has been provided in the Annual Reports from 1953 to 1956 inclusive. In the last issue the entire series was reviewed covering twenty-eight children where treatment was commenced between January 1951 and June 1956. Of this total, fifteen patients had shown evidence of tumour regression, and ten were alive in remission at intervals from 7 months to 6 years from the commencement of treatment. One further child had succumbed to an intercurrent infection (poliomyelitis) and was then found to be free from tumour at autopsy. Regression in the remaining four children was of a temporary nature. Up to June 1957 treatment has been extended to include a further eight patients with neuroblastoma. Case summaries of Cases 31-38 are included.

Case Details

Personal Characteristics

A female infant

Clinical Characteristics

Admitted within three hours of birth because of abdominal swelling. On examination there was gross enlargement of the liver, which extended down to the right iliac fossa. At laparotomy the entire liver was slightly lobular, and biopsy revealed extensive replacement by neuroblastic tissue showing slight differentiation.

Remission Characteristics

There has been a progressive and marked reduction in the size of the liver, the child being in good general health and free from further evidence of metastases at the age of 6 months.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Vitamin b12 therapy was commenced

Additional Notes

In two previous reports (1953, 1954) we have reviewed a series of 19 cases of neuroblastoma treated with massive doses of Vitamin B12. The standard mode of therapy used has consisted of intramuscular injections, each of 1,000 micrograms on alternate days, the course being maintained for from 2 to 2 1/2 years where survival permitted. Since our last report three of the patients reported (Cases 2, 15, 17) have died with a recrudescence of the disease and widespread dissemination of metastases, at intervals of 32, 18 and 21 months respectively from the onset of symptoms. A further group of eight children with verified neuroblastoma has been treated with Vitamin B12; one of these is excluded from the survey as he died within a month from the commencement of treatment, and two others have only recently come under observation. Abstracts of the remaining five cases are given.