Abstract
Crizotinib, an inhibitor of ALK, is expected to improve the outcome of advanced neuroblastoma; however, treatment experience with crizotinib is extremely limited in Japan. Here, we report the case of a patient treated with crizotinib against ALK amplified refractory stage 4 neuroblastoma. Our patient was a girl aged one year and 4 months and diagnosed as having neuroblastoma arising from the left adrenal gland with multiple metastases. She received three courses of the 05A1/05A3 regimen and high-dose chemotherapy, and surgery was subsequently performed. Headache, hypalgesia of the lower limb, movement disorders, and dysuria occurred 17 days after surgery, and spinal cord metastasis was observed by magnetic resonance imaging. Since fluorescence in situ hybridization analysis showed amplified ALK in cells in the cerebrospinal fluid, she received radiotherapy and crizotinib. After 26 days of crizotinib administration, she showed a partial response, but treatment was discontinued as a result of grade 3 vomiting. To confirm the safety and efficacy of crizotinib, further accumulation of experience in the use of crizotinib is important.
