Vincristine‐induced neuropathy in pediatric patients with acute lymphoblastic leukemia in Oman: Frequent autonomic and more severe cranial nerve involvement

Nazir, Hanan; Futaisi, Amna Al; Zacharia, Mathew; Elshinawy, Mohamed; Mevada, Surekha Tony; Al‐Rawas, Abdulhakim; Khater, Doaa; Jaju, Deepali; Wali, Yasser

doi:10.1002/pbc.26677

Cited by 42 publications

(49 citation statements)

References 30 publications

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“…Peripheral (motor, sensory) neuropathies are common, usually caused by vincristine, and are basically completely reversible, but may require many months to improve (4). The study published by Nazir (14) reported that 19 out of 103 pediatric patients developed VCR-related neuropathy. Clinical symptoms started after 2-11 doses of VCR.…”

Section: Discussionmentioning

confidence: 99%

Grade 3 and 4 Toxicity Profiles During Therapy of Childhood Acute Lymphoblastic Leukemia

Zawitkowska

Lejman

Zaucha‐Prażmo

et al. 2019

In Vivo

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Background/Aim: The risk factors, clinical features and non-hematological toxicity profiles during chemotherapy in acute lymphoblastic leukemia (ALL) patients treated in pediatric hematology centres were analysed. Materials and Methods: A total of 902/1872 children were reported as having grade 3 or 4 toxicity. Results: Among the analysed toxicities, infection and gastrointestinal and liver toxicities were the most common. The median follow-up was 6.8 years. Overall survival and event-free survival rates for the analysed group were lower than those reported for the group without grade ≥3 toxicity. In univariate analysis, we identified the number of toxic episodes, the risk group and remission status that had a significant impact on the outcome. Multivariate analysis demonstrated the risk group and the number of toxic episodes ≥3 to be statistically significant for the results. Conclusion: The toxic profiles investigated in our report should be used in future efforts to decrease the burden of side effects during chemotherapy. Over the last years, there has been an improvement in the overall survival of childhood acute lymphoblastic leukemia (ALL), which is now around 80-90%. This is due to contemporary multidrug therapy regimens but, on the other hand, patients are burdened with severe complications of treatment (1, 2). Chemotherapy has a range of side-effects, such as infection, organ damage, hematological and other (malnutrition, hair loss). Most agents causing immunosuppression and myelosuppression increase the risk of bacterial, viral and fungal infections. The infection is still a major cause of death in ALL children (3, 4). Every organ may be adversely affected by anti-leukemic treatment, the most 1333 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 99%

Grade 3 and 4 Toxicity Profiles During Therapy of Childhood Acute Lymphoblastic Leukemia

Zawitkowska

Lejman

Zaucha‐Prażmo

et al. 2019

In Vivo

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“…59 Sjögren's syndrome, 50 vitamin B6 toxicity, 18 cisplatinum toxicity 60 ) Sensory CIDP 61 Abbreviations: CIDP, chronic inflammatory demyelinating polyradiculoneuropathy; HIV, human immunodeficiency virus. 63 heavy metals, organic solvents, acrylamide, 64 cisplatin, 60 vincristine, 65 paclitaxel, 66…”

Section: Leukemiamentioning

confidence: 99%

“…Vincristine neuropathy 65 Abbreviations: HIV, human immunodeficiency virus; HSAN, hereditary sensory and autonomic neuropathy. sensory neuropathy will have normal motor NCS, the loss of sensory feedback will often lead to a sense of weakness or abnormal motor function.…”

Section: Leprosy 27 )mentioning

confidence: 99%

A Clinician's Approach to Peripheral Neuropathy

Siao

Kaku

2019

Semin Neurol

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Peripheral neuropathies are a group of disorders that affect the peripheral nervous system, for which hundreds of etiologies have been identified. This article presents a stepwise approach to the evaluation and workup of peripheral neuropathy, which starts with a detailed history of symptoms, family and occupational history, and a neurological as well as general physical exam. Pattern recognition of various neuropathies can help to build a differential diagnosis based on the presentation. Such patterns include acute versus chronic, primary demyelinating versus axonal, hereditary versus acquired, asymmetric versus symmetric, presence of facial palsies, sensory or motor predominant, and presence of prominent autonomic symptoms. Early categorization of the type of neuropathy can help focus the workup for peripheral neuropathy. Nerve conduction studies and electromyography (NCS/EMG) is the primary diagnostic tool in the evaluation of patients with large-fiber polyneuropathy. One of the most important roles of NCS/EMG is to help categorize polyneuropathy as primary axonal versus primary demyelinating. The finding of a primary demyelinating polyneuropathy narrows the differential diagnosis of polyneuropathy dramatically and increases the chances of finding a treatable etiology. Laboratory workup includes serum studies and potentially cerebrospinal fluid, genetic studies, immunological markers, and fat pad biopsy for select patients. Skin biopsy may be used to assess intraepidermal nerve fiber density if small-fiber neuropathy is suspected, and nerve biopsy may be useful in select cases. In recent years, magnetic resonance imaging and neuromuscular ultrasound have also shown promise in the evaluation of peripheral neuropathy. Identification of the etiology of neuropathy is crucial and often time-sensitive, as an increasing number of causes are now reversible or treatable.

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“…Peripheral neuropathy is a common adverse effect of vincristine. Peripheral neuropathy can affect motor, sensory, and autonomic peripheral nerve fibers 2,3 Rarely cranial nerves are involved. 3 Neuropathy is reported in 3 to 93% children treated with vincristine.…”

Section: Introductionmentioning

confidence: 99%

“…Peripheral neuropathy can affect motor, sensory, and autonomic peripheral nerve fibers 2,3 Rarely cranial nerves are involved. 3 Neuropathy is reported in 3 to 93% children treated with vincristine. 3,4 Symmetrical motor axonal polyneuropathy is the most common pattern of involvement seen with vincristine.…”

Section: Introductionmentioning

confidence: 99%

Vincristine Neuropathy in Children: Squatting (Sitting Cross Legged) Predisposes Common Peroneal Nerves to Be More Severely Affected than Tibial Nerves

Koul

Harousi

AlNabhani

et al. 2019

Journal of Pediatric Neurology

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Abstract Objective The main objective of this article was to evaluate vincristine neuropathy effect on common peroneal and tibial nerves. Methods A retrospective study was conducted in children with vincristine neuropathy between August 2006 and January 2016 at Sultan Qaboos University Hospital. Results Twenty-eight children (15 females and 13 males) were included in the study. The compound muscle action potential of common peroneal nerves was significantly reduced relative to the tibial nerves (p < 0.05)). There was no difference in latency and nerve conduction velocity between the two nerves. Conclusion Children receiving vincristine demonstrate severe peroneal neuropathy compared with tibial nerves. We conclude that squatting posture effects peroneal nerves and postulate that the peroneal nerves are affected more due to the squatting posture. This squatting posture stretches the nerves that are already affected by the toxic effect of vincristine.

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Vincristine‐induced neuropathy in pediatric patients with acute lymphoblastic leukemia in Oman: Frequent autonomic and more severe cranial nerve involvement

Cited by 42 publications

References 30 publications

Grade 3 and 4 Toxicity Profiles During Therapy of Childhood Acute Lymphoblastic Leukemia

Grade 3 and 4 Toxicity Profiles During Therapy of Childhood Acute Lymphoblastic Leukemia

A Clinician's Approach to Peripheral Neuropathy

Vincristine Neuropathy in Children: Squatting (Sitting Cross Legged) Predisposes Common Peroneal Nerves to Be More Severely Affected than Tibial Nerves

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