Introduction: Vincristine is used in many therapeutic schemes of oncological treatment in children, and one of its common complications is neurotoxicity. The aim of this study was to assess the incidence of vincristine-induced polyneuropathy in children treated for acute lymphoblastic leukemia. Secondly, we evaluated the clinical spectrum of chemotherapy-induced peripheral neuropathy.
Material and methods:The study included 29 patients with newly diagnosed acute lymphoblastic leukemia who were treated according to the ALL IC-BFM 2009 therapeutic program. The study was designed for the induction remission phase, in which patients received unified anticancer treatment. A neurological assessment was performed on days 1, 8, 15, 22, 29 and 36 of treatment, and consisted of an original questionnaire completed by patients or their caregivers, a physical examination, and a neurological examination. Abnormalities were assessed according to the Common Terminology Criteria for Adverse Events, version 5.0 scale.Results: Symptoms of polyneuropathy occurred in 25 patients (86.2%). Motor neuropathy was the most common type of polyneuropathy in the examined group. In half of the cases, the polyneuropathy was severe, rated at 3 or 4 points. The most serious course manifested itself in three patients in severe gastrointestinal ileus with subsequent intestinal perforation. In another case, rated at 4 points, breathing disorders occurred with apnea episodes.Conclusions: Vincristine-induced polyneuropathy is common in children with acute lymphoblastic leukemia in the induction of remission phase, and is severe in half of cases. In the pediatric population, in contrast to adults, vincristine--induced polyneuropathy motor symptoms are predominant.