Nursing Management of Anti-GD2 Dinutuximab-Related Adverse Effects in Children with Neuroblastoma: A Scoping Review

Background: Anti-disialoganglioside GD2 (anti-GD2) immunotherapy, particularly dinutuximab, has significantly improved survival outcomes in children with high-risk neuroblastoma. However, treatment is frequently associated with severe adverse effects, including neuropathic pain, hypersensitivity reactions, and capillary leak syndrome, which present major challenges to patient comfort and treatment adherence.

Aim: This scoping review aimed to map the existing literature on dinutuximab-related adverse effects and the strategies used to manage them.

Methods: A comprehensive search was conducted across multiple databases for studies published between 2010 and 2024. Clinical trials, cohort studies, case series, and expert recommendations involving pediatric patients receiving dinutuximab were included. A narrative synthesis was used to integrate and interpret the findings.

Results: The initial database search identified 962 studies, of which 29 met the inclusion criteria. Pain, hypersensitivity reactions, and infusion-related complications were the most frequently reported adverse events. Current evidence supports multimodal analgesia, standardized premedication protocols, and nursing-led supportive care to mitigate these toxicities. To our knowledge, this is the first scoping review to synthesize both pharmacological and nursing-led support-ive care strategies for managing dinutuximab-related toxicities in children with high-risk neuroblastoma.

Conclusion: This review highlights the importance of multidisciplinary management and standardized, nursing-inclusive care pathways to improve treatment tolerability and optimize outcomes in children receiving anti-GD2 therapy.

Keywords: Anti-GD2, children, dinutuximab, neuroblastoma, nursing, side effects