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. 2015 Mar;20(1):37-46.
doi: 10.1111/jns.12114.

Patterns and severity of vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia

Ellen M Lavoie Smith  1 , Lang Li  2 , ChienWei Chiang  2 , Karin Thomas  3 , Raymond J Hutchinson  1 , Elizabeth M Wells  4 , Richard H Ho  5 , Jodi Skiles  2 , Arindom Chakraborty  2 , Celia M Bridges  1 , Jamie Renbarger  2
Affiliations

Patterns and severity of vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia

Ellen M Lavoie Smith et al. J Peripher Nerv Syst. 2015 Mar.

Abstract

Vincristine, a critical component of combination chemotherapy treatment for pediatric acute lymphoblastic leukemia (ALL), can lead to vincristine-induced peripheral neuropathy (VIPN). Longitudinal VIPN assessments were obtained over 12 months from newly diagnosed children with ALL (N = 128) aged 1-18 years who received vincristine at one of four academic children's hospitals. VIPN assessments were obtained using the Total Neuropathy Score-Pediatric Vincristine (TNS©-PV), National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE©), Balis© grading scale, and Pediatric Neuropathic Pain Scale©-Five (PNPS©-5). Of children who provided a full TNS©-PV score, 85/109 (78%) developed VIPN (TNS©-PV ≥4). Mean TNS©-PV, grading scale, and pain scores were low. CTCAE©-derived grades 3 and 4 sensory and motor VIPN occurred in 1.6%/0%, and 1.9%/0% of subjects, respectively. VIPN did not resolve in months 8-12 despite decreasing dose density. VIPN was worse in older children. Partition cluster analysis revealed 2-3 patient clusters; one cluster (n = 14) experienced severe VIPN. In this population, VIPN occurs more commonly than previous research suggests, persists throughout the first year of treatment, and can be severe.

Keywords: acute lymphoblastic leukemia; children; patterns; severity; vincristine-induced peripheral neuropathy.

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Figures

Figure 1
Figure 1
(A) Total Neuropathy Score-Pediatric Vincristine (TNS©-PV) Subjective Symptom Scores in first 12 months (n = 109). (B) TNS©-PV Objective Sign Scores in first 12 months (n = 109).
Figure 2
Figure 2
Total Neuropathy Score-Pediatric Vincristine (TNS©-PV) Mean Total Score and dose density by cluster (n = 109).
Figure 3
Figure 3
Mean Total Neuropathy Score-Pediatric Vincristine (TNS©-PV) Item Scores by cluster (n = 109).
See this image and copyright information in PMC

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