Weakness and numbness after chemotherapy for metastatic non-seminoma testis: A new neurological complication

Verdonk, Robert C.; Enting, Roelien H.; Janmaat, Mirjam; Schroder, C.; Sleijfer, Dirk; Gietema, Jourik A.

doi:10.1080/02841860701877330

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…Although a formal link between GBS and platinum chemotherapy has not been established yet, among 449 patients with solid tumors in our database, GBS was diagnosed exclusively in those receiving platinum compounds. All five literature cases were also associated with platinum administration , making plausible the assumption that there is a pathophysiological link between platinum administration and GBS. Evidence suggests in fact that platinum compounds may act as triggers of autoimmunity by inducing an elevation of proinflammatory cytokines (tumor necrosis factor‐α and interleukin‐6) and by enhancing anticancer immune responses, which could in turn facilitate the development of an immune reaction towards myelin antigens .…”

Section: Discussionmentioning

confidence: 93%

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Guillain-Barré Syndrome During Platinum-Based Chemotherapy: A Case Series and Review of the Literature

et al. 2019

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Platinum-based chemotherapy is commonly associated with toxic sensory neuropathies, but also, although rarely, with Guillain-Barré syndrome (GBS). We describe five patients who developed GBS while receiving platinum-based chemotherapy for a solid tumor and report the five cases published so far. Most patients had received cumulative platinum doses below known neurotoxic levels, and all of them had an optimal outcome after platinum discontinuation, associated in most cases with administration of intravenous immunoglobulin. Clinical presentation, electroneuromyography, and cerebrospinal fluid analysis help clinicians to differentiate GBS from toxic neuropathy. Platinum compounds are the only chemotherapeutic agents used for solid tumors that have been associated to GBS. Thus, we propose that GBS may constitute a non-dosedependent side effect of platinum drugs and that awareness needs to be raised among oncologists on this rare but potentially life-threatening complication of platinum chemotherapy. The Oncologist 2020;25:e194-e197 Implications for Practice: Many patients on platinum-based chemotherapy for solid tumors develop sensory neuropathy, a common dose-dependent side effect. The authors propose that Guillain-Barré syndrome may constitute an immunemediated, non-dose-related side effect of platinum-based chemotherapy. Prompt diagnosis of Guillain-Barré syndrome and distinction from classical toxic neuropathy are crucial for optimal treatment. Platinum discontinuation, associated if needed to intravenous immunoglobulin administration, radically changes the course of the disease and minimizes neurological sequelae.The Oncologist 2020;25:e194-e197 www.TheOncologist.com Brief Communications 11. Vigliani MC, Magistrello M, Polo P et al.; Piemonte and Valle d'Aosta Register for Guillain-Barré Syndrome. Risk of cancer in patients with Guillain-Barré syndrome (GBS). A population-based study.

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Section: Discussionmentioning

confidence: 93%

“…We identified five previously published cases of patients with GBS during chemotherapy for solid tumors, all of whom had received platinum compounds as part of their chemotherapy regimen (Table ) . Three out of the five patients had received cumulative platinum doses below neurotoxic levels.…”

Section: Resultsmentioning

confidence: 99%

Guillain-Barré Syndrome During Platinum-Based Chemotherapy: A Case Series and Review of the Literature

et al. 2019

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“…Therefore, when motor and autonomic symptoms are predominant and/or there is an absence of sensory involvement, an alternative diagnosis should be considered. As an example, platinum‐based compounds have been rarely associated with acute inflammatory demyelinating polyradiculoneuritis in patients with solid tumor, which appears to respond well to standard immunotherapy. Additionally, it is important to be aware that treatment with more than one neurotoxic agent may increase the likelihood of peripheral neuropathy, which may be associated with involvement of the autonomic system (especially parasympathetic heart innervation) …”

Section: Clinical Aspects Of Pipnmentioning

confidence: 99%

Platinum‐induced peripheral neurotoxicity: From pathogenesis to treatment

Staff

Cavaletti

Islam

et al. 2019

J Peripheral Nervous Sys

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Platinum-induced peripheral neurotoxicity (PIPN) is a common side effect of platinum-based chemotherapy that may cause dose reduction and discontinuation, with oxaliplatin being more neurotoxic. PIPN includes acute neurotoxicity restricted to oxaliplatin, and chronic non-length-dependent sensory neuronopathy with positive and negative sensory symptoms and neuropathic pain in both upper and lower limbs.Chronic sensory axonal neuropathy manifesting as stocking-and-glove distribution is also frequent. Worsening of neuropathic symptoms after completing the last chemotherapy course may occur. Motor and autonomic involvement is uncommon. Ototoxicity is frequent in children and more commonly to cisplatin. Platinum-based compounds result in more prolonged neuropathic symptoms in comparison to other chemotherapy agents. Patient reported outcomes questionnaires, clinical evaluation and instrumental tools offer complementary information in PIPN. Electrodiagnostic features include diffusely reduced/abolished sensory action potentials, in keeping with a sensory neuronopathy. PIPN is dependent on cumulative dose but there is a large variability in its occurrence. The search for additional risk factors for PIPN has thus far yielded no consistent findings. There are currently no neuroprotective strategies to reduce the risk of PIPN, and symptomatic treatment is limited to duloxetine that was found effective in a single phase III intervention study. This review critically examines the pathogenesis, incidence, risk factors (both clinical and pharmacogenetic), clinical phenotype and management of PIPN.

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“…The link between GBS and chemotherapy has not been established yet; however, a possible explanation for this association is that the treatment generates a transient state of immunosuppression that can increase immunologically mediated damage to the myelin sheath catalyzed by the tumor epitope [6]. Also, platinum chemotherapy could increase the production of circulating TNF-a and interleukin-6 involved in the development of GBS [7].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, GBS associated with solid tumors and hematological malignancies is rare; however, GBS cases associated with lymphomas, leukemias, lung, breast, and colon cancer have been reported [7]. Tumor cells can produce onconeural antigens that stimulate onconeural antibody production like molecular mimicry in infectious processes [6].…”

Section: Introductionmentioning

confidence: 99%

Guillain-Barre Syndrome Amid Osteosarcoma Treatment: A Therapeutic Dilemma and Literature Review

Suárez¹,

Deng²,

Silva³

et al. 2021

Cureus

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Guillain-Barre syndrome (GBS) is a clinical syndrome with multiple variants. GBS is defined as an acute demyelinating polyneuropathy commonly preceded by infection (bacterial or viral), trauma, or inflammatory processes, which triggers an autoimmune response that affects the peripheral nervous system. This case report describes a patient with high-grade osteosarcoma that completed neoadjuvant chemotherapy and underwent surgical resection with no immediate complications. Fourteen days after the surgery, the patient developed an acute inflammatory demyelinating polyradiculopathy consistent with GBS. As the five-year survival without chemotherapy is only around 20%, this challenging clinical scenario raised questions regarding adjuvant chemotherapy's safe completion in this setting.

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Weakness and numbness after chemotherapy for metastatic non-seminoma testis: A new neurological complication

Abstract: (2008) Weakness and numbness after chemotherapy for metastatic non-seminoma testis: A new neurological complication,

Cited by 4 publications

References 10 publications

Guillain-Barré Syndrome During Platinum-Based Chemotherapy: A Case Series and Review of the Literature

Guillain-Barré Syndrome During Platinum-Based Chemotherapy: A Case Series and Review of the Literature

Platinum‐induced peripheral neurotoxicity: From pathogenesis to treatment

Guillain-Barre Syndrome Amid Osteosarcoma Treatment: A Therapeutic Dilemma and Literature Review

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