Definition:
- Blastomas are malignant tumors arising from immature precursor (blast) cells of a specific organ or tissue.
- Characterized by rapid proliferation of embryonal-like cells and often seen in pediatric cancers.
- The suffix “-blastoma” denotes the tissue of origin:
| Blastoma Type | Tissue of Origin | Key Notes / Pharmacist Pearls |
|---|---|---|
| Neuroblastoma | Sympathetic nervous system (neural crest) | Chemo: cyclophosphamide, vincristine, doxorubicin, cisplatin; monitor myelosuppression, neuropathy, nephrotoxicity |
| Wilms tumor (Nephroblastoma) | Kidney (metanephric blastema) | Chemo: vincristine ± actinomycin D ± doxorubicin; monitor renal/hepatic function, myelosuppression |
| Hepatoblastoma | Liver (hepatoblasts) | Chemo: cisplatin ± doxorubicin; monitor nephrotoxicity, ototoxicity, cardiotoxicity |
| Retinoblastoma | Retina (retinoblasts) | Chemo: vincristine, carboplatin ± etoposide; monitor myelosuppression, neuropathy, renal function |
| Medulloblastoma | Cerebellar precursor cells | Chemo: cisplatin, vincristine, cyclophosphamide; monitor nephrotoxicity, neuropathy, myelosuppression |
High-Yield Pharmacist Considerations Across Blastomas
- Rapidly dividing cells → highly sensitive to chemotherapy
- Pediatric dosing → BSA- or weight-based; careful organ function monitoring
- Supportive care → hydration, antiemetics, growth factors, transfusions
- Toxicity monitoring: myelosuppression, neuropathy, nephrotoxicity, cardiotoxicity depending on regimen
- Long-term follow-up: growth, organ function, secondary malignancies