Clinical trial of folinic acid to reduce vincristine neurotoxicity

Jackson, Don V.; McMahan, Rebecca; Pope, Ellen; Case, L. Douglas; Cooper, M. Robert; Kaplon, Michael K.; Richards, Frederick; Stuart, John J.; White, Dougľas R.; Zekan, Patricia J.

doi:10.1007/bf00256700

Cited by 39 publications

(11 citation statements)

References 8 publications

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“…Folinic acid and pyridoxine have been tried as possible antidotes but gave no protection. 15,16 Recently, oral glutamic acid therapy has been tested, with encouraging results. 17 Results from animal experiments and human observations show that the administration of lithium may counteract vincristineinduced neurotoxic effects.…”

Section: Commentmentioning

confidence: 99%

The Natural History of Vincristine-Induced Laryngeal Paralysis in Children

Kuruvilla

Perry²,

Wilson³

et al. 2009

Arch Otolaryngol Head Neck Surg

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Objective: To outline the natural history of vincristineinduced laryngeal paralysis (VLP) in children.Design: Retrospective case series and review of reported cases in the English-language literature.Setting: Tertiary pediatric center. Patients:The study included all children with a confirmed diagnosis of VLP by inspection and with complete clinical information. The sources for patient identification were a prospectively kept database and a review of the English-language literature, conducted on PubMed since 1966, as well as a bibliography search. Main Outcome Measures:Charts and literature were reviewed for demographics, primary diagnosis, other diagnoses, and duration and method of treatment. The prevalence of VLP, locally, was also calculated.Results: Four children (3 boys and 1 girl) were identified in our database over a 5 1 ⁄2-year period, and 10 children (1 girl, 8 boys, and 1 with sex omitted) were described in the English-language literature. Four children had unilateral vocal fold paralysis only, all left-sided. The median age was 2.6 years. Acute lymphoblastic leukemia was the underlying diagnosis in 8 patients. Two patients had Down syndrome, and 1 patient had CharcotMarie-Tooth disease, type 1. Only 2 patients required tracheotomies, and 1 patient was treated temporarily with bilevel positive-pressure ventilation. The median duration of paralysis was 6.8 weeks. The prevalence of VLP was 1.36%. Conclusions:The data suggest that VLP is probably underreported and possibly underdiagnosed. Endoscopic inspection is a must in all patients with airway symptoms who are receiving vicristine therapy. Early recognition of VLP is mandatory, as it is reversible, has a good prognosis, and usually needs only interruption of vincristine therapy and conservative treatment.

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Section: Commentmentioning

confidence: 99%

The Natural History of Vincristine-Induced Laryngeal Paralysis in Children

Kuruvilla

Perry²,

Wilson³

et al. 2009

Arch Otolaryngol Head Neck Surg

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“…Glutamic acid, ORG-2766 (an adrenocorticotrophic hormone analogue) and noscapine have also been stated to protect against vincristine-induced neuropathy. Folinic acid has also been used successfully in a small number of vincristine overdosages in humans 13 15 16…”

Section: Discussionmentioning

confidence: 99%

Vincristine-induced unilateral ptosis with serendipitous response to modafinil

Revannasiddaiah

Bhattacharyya²

2011

Case Reports

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“…The earliest and most prominent symptom of peripheral neuropathy is loss of the Achilles tendon reflexes. 6,7 The higher the dose of the drug and the longer the treatment period, the more severe the drugrelated neurotoxicity. In one study, sensory neuropathy was found in one third of patients 77 months after cessation of therapy.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Clinical Outcome After Accidental Overdose of Multiple Chemotherapeutic Agents

Üner¹,

Özet²,

Arpacı³

et al. 2005

Pharmacotherapy

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Treatment of non-Hodgkin's lymphoma with the CHOP regimen consists of intravenous cyclophosphamide 750 mg/m2 (day 1), intravenous doxorubicin 50 mg/m2 (day 1), intravenous vincristine 1.4 mg/m2 (day 1), and oral prednisone 100 mg (days 1-5). This regimen is administered in cycles of approximately 3 weeks; a total course of treatment consists of six cycles. We report the case of a 23-year-old woman with diffuse large-cell lymphoma who received an accidental overdose of this chemotherapeutic regimen. The first cycle of her CHOP regimen was initiated (day 1) in our outpatient unit; she was then discharged home. Unfortunately, the patient went to another hospital located in the small city where she lived, and all remaining doses of the total course of treatment were administered over the next 5 consecutive days, with no interruption in therapy. She had received cumulative doses of cyclophosphamide 6000 mg, doxorubicin 420 mg, and vincristine 12 mg. She was transferred to our hospital after she developed pancytopenia, fever, and ileus. With the help of intensive supportive care and symptomatic treatment, the patient recovered and was discharged home after a hospital stay of 25 days. After 56 months, she was free of disease and treatment-related toxicities. Only experienced clinicians should administer chemotherapy, and thorough records must be kept to document the chemotherapy administered, dosages, dates of administration, the procedure used, and the schedule of cycles administered.

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Clinical trial of folinic acid to reduce vincristine neurotoxicity

Cited by 39 publications

References 8 publications

The Natural History of Vincristine-Induced Laryngeal Paralysis in Children

The Natural History of Vincristine-Induced Laryngeal Paralysis in Children

Vincristine-induced unilateral ptosis with serendipitous response to modafinil

Long-Term Clinical Outcome After Accidental Overdose of Multiple Chemotherapeutic Agents

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