This article reported the clinical pharmacist's involvement in the treatment of a high-risk neuroblastoma pediatric patient with naxitamab and the implementation of individualized medication monitoring. Upon admission, the clinical pharmacist collaborated with the physician to develop a dosing regimen and an allergy-prevention plan for naxitamab. On the day of administration, the pediatric patient experienced an infusion-related reaction. After evaluating by the physician and clinical pharmacist, the pediatric patient was administed albumin for volume expansion, electrolyte supplementation, vasopressor support, and mechanical ventilation, while temporarily suspending naxitamab infusion. Concurrent anti-inflammatory and infection-prevention therapies led to the pediatric patient's improvement, allowing the completion of the remaining three naxitamab infusions. The clinical pharmacist provided pharmaceutical recommendations for infusion-related pain, rash, and hypotension, which were adopted by the physician. As one of the earliest cases of naxitamab use in China, this case highlighted the role of clinical pharmacists in pharmaceutical care for patient with complex conditions, particularly in optimizing treatment plans and ensuring medication safety, offering practical experience and reference for the rational use of naxitamab in pediatric patients.

1.Irwin MS, Naranjo A, Zhang FF, et al. Revised neuroblastoma risk classification system: a report from the children's oncology group[J]. J Clin Oncol, 2021, 39(29): 3229-3241. DOI: 10.1200/JCO.21.00278.

2.Katano M, Irie RF. Human monoclonal antibody to tumor-associated ganglioside GD2: suppressed growth of human melanoma in nude mice[J]. Immunol Lett, 1984, 8(4): 169-174. DOI: 10.1016/0165-2478(84)90072-5.

3.Yang RK, Sondel PM. Anti-GD2 strategy in the treatment of neuroblastoma[J]. Drugs Future, 2010, 35(8): 665. DOI: 10.1358/dof.2010.035.08.1513490.

4.Cheung NK, Cheung IY, Kushner BH, et al. Murine anti-GD2 monoclonal antibody 3F8 combined with granulocyte-macrophage colony-stimulating factor and 13-cis-retinoic acid in high-risk patients with stage 4 neuroblastoma in first remission[J]. J Clin Oncol, 2012, 30(26): 3264-3270. DOI: 10.1200/JCO.2011. 41.3807.

5.Yu AL, Gilman AL, Ozkaynak MF, et al. Anti-GD2 antibody with GM-CSF, interleukin-2, and isotretinoin for neuroblastoma[J]. N Engl J Med, 2010, 363(14): 1324-1334. DOI: 10.1056/NEJMoa0911123.

6.Ladenstein R, Pötschger U, Valteau-Couanet D, et al. Investigation of the role of dinutuximab beta-based immunotherapy in the SIOPEN High-Risk Neuroblastoma 1 Trial (HR-NBL1)[J]. Cancers (Basel), 2020, 12(2): 309. DOI: 10.3390/cancers12020309.

7.Desai AV, Gilman AL, Ozkaynak MF, et al. Outcomes following GD2-directed postconsolidation therapy for neuroblastoma after cessation of random assignment on ANBL0032: a report from the Children's Oncology Group[J]. J Clin Oncol, 2022, 40(35): 4107-4118. DOI: 10.1200/JCO.21.02478.

8.神经母细胞瘤免疫治疗临床应用协作组. 抗GD2单抗那西妥单抗治疗神经母细胞瘤临床应用专家共识（2024 年版） [J]. 世界临床药物, 2024, 45(11): 1105-1115. DOI: 10.13683/j.wph. 2024.11.001.

9.Chan GC, Chan CM. Anti-GD2 directed immunotherapy for high-risk and metastatic neuroblastomas[J]. Biomolecule, 2022, 12(3): 358. DOI: 10.3390/biom12030358.

10.Bagatell R, DuBois SG, Naranjo A, et al. Children's Oncology Group's 2023 blueprint for research: neuroblastoma[J]. Pediatr Blood Cancer, 2023, 70(Suppl 6): e30572. DOI: 10.1002/pbc.30572.

11.US Department of Health and Human Services. Common Terminology Criteria for Adverse Events v4.0 (CTCAE) [R/OL]. (2017-07-20) [2025-02-10]. https://ctep.cancer.gov/protocol/Development/electronic_applications/ctc.

12.Su Y, Qin H, Chen C, et al. Treatment and outcomes of 1041 pediatric patients with neuroblastoma who received multidisciplinary care in China[J]. Pediatr Investig, 2020, 4(3): 157-167. DOI: 10.1002/ped4.12214.

13.Mora J, Castañeda A, Gorostegui M, et al. Naxitamab combined with granulocyte-macrophage colony-stimulating factor as consolidation for high-risk neuroblastoma patients in complete remission[j]. Pediatr Blood Cancer, 2021, 68(10): e29121. DOI: 10.1002/pbc.29121.

14.Mody R, Yu AL, Naranjo A, et al. Irinotecan, temozolomide, and dinutuximab with GM-CSF in children with refractory or relapsed neuroblastoma: a report from the Children's Oncology Group[J]. J Clin Oncol, 2020, 38(19): 2160-2169. DOI: 10.1200/JCO.20.00203.

15.Cheung IY, Hsu K, Cheung NK. Activation of peripheral-blood granulocytes is strongly correlated with patient outcome after immunotherapy with anti-GD2 monoclonal antibody and granulocyte-macrophage colony-stimulating factor[J]. J Clin Oncol, 2012, 30(4): 426-432. DOI: 10.1200/JCO.2011.37.6236.

16.Slatnick LR, Jimeno A, Gore L, et al. Naxitamab: a humanized anti-glycolipid disialoganglioside (anti-GD2) monoclonal antibody for treatment of neuroblastoma[J]. Drugs Today (Barc), 2021, 57(11): 677-688. DOI: 10.1358/dot.2021.57.11.3343691.

17.Mora J, Chan GC, Morgenstern DA, et al. Outpatient administration of naxitamab in combination with granulocyte-macrophage colony-stimulating factor in patients with refractory and/or relapsed high-risk neuroblastoma: management of adverse events[J]. Cancer Rep (Hoboken), 2023, 6(1): e1627. DOI: 10.1002/cnr2.1627.

18.Angelhescu DL, Oakes LL. Ketamine use for reduction of opioid tolerance in a 5-year-old girl with end-stage abdominal neuroblastoma[J]. J Pain Symptom Manage, 2005, 30(1): 1-3. DOI: 10.1016/j.jpainsymman.2005.05.007.

19.Kushner BH, Cheung IY, Modak S, et al. Humanized 3F8 anti-GD2 monoclonal antibody dosing with granulocyte-macrophage colony-stimulating factor in patients with resistan neuroblastoma: a phase 1 clinical trial[J]. JAMA Oncol, 2018, 4: 1729-1735. DOI: 10.1001/jamaoncol.2018.4005.

20.Mora J, Chan GCF, Morgenstern DA, et al. The anti-GD2 monoclonal antibody naxitamab plus GM-CSF for relapsed or refractory high-risk neuroblastoma: a phase 2 clinical trial[J]. Nat Commun, 2025, 16(1): 1636. DOI: 10.1038/s41467-025-56619-x.

21.Yan W, Liu F, Li X, et al. Blood pressure percentiles by age and height for non-overweight Chinese children and adolescents: analysis of the China health and nutrition surveys 1991-2009[J]. BMC Pediatr, 2013, 13: 195. DOI: 10.1186/1471-2431-13-195.