Abstract
Ten out of 20 children, treated with usual doses of vincristine for various types of childhood cancers, developed neurotoxicity during treatment. Peripheral neurotoxicity (mixed motor-sensory 4/10, pure motor 3/10, pure sensory 3/10) was seen in the form of weakness of lower limbs, areflexia, neuropathic pain, or sensory loss. Autonomic neuropathy presented as constipation and urinary retention in 2 children, while 2 children developed encephalopathy in form of seizures, confusion, aphasia, and transient blindness. In children with severe neuropathy, vincristine administration was withheld/dose reduced till clinical improvement started, which took about 2–3 weeks time. Nerve conduction velocity showed motor-sensory axonal polyneuropathy. Electrophysiological abnormalities were found to persist even six months after clinical recovery in children with neurotoxicity. We found a relatively higher incidence of vincristine induced neuropathy in Indian children, which was probably due to coexistence of severe malnutrition in them.
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References
Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy. J Neurol 2002;249:9–17.
Rosenthal S, Kaufman S. Vincristine neurotoxicity. Ann Med 1974;80:733–737.
Advani S, Pai S, Venzon D et al. Acute lymphoblastic leukemia in India: an analysis of prognostic factors using a single treatment regimen. Ann Oncol 1999;10:167–176.
Magrath I, Shanta V, Advani S et al. Treatment of acute lymphoblastic leukemia in countries with limited resources; lessons from use of a single protocol in India over a twenty year period. Eur J Cancer 2005;41:1570–1583.
Loeffler M, Diehl V, Pfreundschuh M et al. Dose-response relationship of complementary radiotherapy following four cycles of combination chemotherapy in intermediate-stage Hodgkin’s disease. J Clin Oncol 1997;15:2275.
Ritchey M. Pediatric Urologic Oncology. In Campbell MF, Walsh PC, Retik AB, ed. Campbell’s Urology. 8th ed. Philadelphia; Saunders, 2002;2469–2475.
Ray M, Marwaha RK, Trehan A. Chemotherapy related fatal neurotoxicity during induction in acute lymphoblastic leukemia. Indian J Pediatr 2002;69:185–187.
Ochs JJ. Neurotoxicity due to central nervous system therapy for childhood leukemia. Am J Pediatr Hematol Oncol 1989;11:95–105.
Centers for Disease Control and Prevention National Health and Nutrition Examination survey: http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/clinical_charts.htm
Kumar N. Nutritional neuropathies. Neurol Clin 2007;25:209–255.
Weber GA, Sloan P, Davies D. Nutritionally induced peripheral neuropathies. Clin Podiatr Med Surg 1990;7:107–128.
Robson D, Welch E, Beeching NJ, Gill GV. Consequences of captivity: health effects of far East imprisonment in World War II. QJM 2008. [Epub ahead of print]
Madhusudanan M, Menon MK, Ummer K, Radhakrishnan K. Clinical and etiological profile of tropical ataxic neuropathy in Kerala, South India. Eur Neurol 2008;60:21–26.
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Gomber, S., Dewan, P. & Chhonker, D. Vincristine induced neurotoxicity in cancer patients. Indian J Pediatr 77, 97–100 (2010). https://doi.org/10.1007/s12098-009-0254-3
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DOI: https://doi.org/10.1007/s12098-009-0254-3