Vincristine induced neurotoxicity in cancer patients

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.

Cerebello–thalamo–cerebral connections in pediatric brain tumor patients: Impact on working memory

“…Methotrexate was not used in any protocols for the present sample. Although the chemotherapy agents used to treat pediatric brain tumors have not been associated with significant neurocognitive late effects, peripheral neuropathy resulting in motor slowing can be observed following treatment with vincristine (Gomber et al, 2010;Ramchandren et al, 2009), and auditory toxicity that may interfere with measurement of auditory-verbal functions can be associated with cisplatin (McHaney et al, 1983;Weatherly et al, 1991). There is a possibility that the chemotherapeutic agents used to treat pediatric brain tumors have an impact on cognitive function and thus requires continued examination.…”

Chemotherapy-induced peripheral neuropathy: clinical features, diagnosis, prevention and treatment strategies

“…Some are being investigated as potential neuroprotectors, as seen below. Malnourished and alcoholic patients and those with previous gastrointestinal surgery are at special risk of developing neuropathy [62,63], since some of these essential vitamins have had their absorption compromised.…”

Prevalence of vincristine induced-peripheral neuropathy among Sudanese cancer patients

“…relatively higher incidence of vincristine-induced neuropathy in Indian children and authors attributed it to coexistence of severe malnutrition in those patients. 16 According to one research finding, vincristine causes peripheral neuropathy and the patients who suffers peripheral neuropathy experiences problems related to cardiovascular, gastrointestinal and genitourinary systems. 16 In addition, patients who experienced peripheral neuropathy, a side-effect from chemotherapy could be disabled after using antineoplastic agents.…”

“…16 According to one research finding, vincristine causes peripheral neuropathy and the patients who suffers peripheral neuropathy experiences problems related to cardiovascular, gastrointestinal and genitourinary systems. 16 In addition, patients who experienced peripheral neuropathy, a side-effect from chemotherapy could be disabled after using antineoplastic agents. 17 One study noticed, in children the lower age could resulted in greater sensitivity of some nerves to vincristine and thus showing a motor predominant neuropathy in children.…”