High incidence of vincristine-induced neuropathy in lymphomas.

Watkins, Sylvia M.; Griffin, Jessica

doi:10.1136/bmj.1.6113.610

Cited by 40 publications

(10 citation statements)

References 5 publications

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“…Furthermore, several studies report advanced age in pediatric patients as a clinical risk factor [61, 69, 73]. However, some studies do not find this correlation in pediatric or adult patients [44, 49] and others even suggest the opposite for both groups [54, 88, 95].…”

Section: Resultsmentioning

confidence: 99%

“…It has been suggested that neuropathy incidence could be disease dependent given that a significantly higher incidence in patients suffering from lymphoma is observed compared with nonlymphoid cancer patients (e.g., leukemia, breast cancer, malignant melanoma) [88]. Fourteen out of 23 patients with lymphoma and 5/37 patients without lymphoma developed neuropathy despite comparable dosage [88], and concordant observations were made by others [46]. A higher percentage of lymphoma patients have elevated levels of serum alkaline phosphatase, which significantly prolongs elimination of vincristine and results in longer vincristine exposure and associated toxicities [46].…”

Section: Resultsmentioning

confidence: 99%

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Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review

Madsen

Due

Ejskjær

et al. 2019

Cancer Chemother Pharmacol

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Purpose Vincristine is widely used as anticancer therapy for a variety of hematological malignancies. The treatment is limited by progressive vincristine-induced neuropathy, possibly including both peripheral sensory and motor nerves, autonomic nervous functions, and the central nervous system. This dose-limiting side-effect can diminish quality of life and, furthermore, cause discontinuation of vincristine treatment. The present review elucidates the current knowledge regarding vincristine-induced neuropathy in hematologic malignancies, focusing on neuropathy assessment, clinical and molecular predictive markers, drug–drug interference, prevention, and treatment. Methods This review is conducted by a systematic search strategy for the identification of relevant literature in the PubMed and Embase databases. Results No clinical parameters displayed convincing potential as predictors of vincristine-induced neuropathy; however, preexisting neuropathy was consistently reported to be associated with an increased risk of neurotoxicity. In contrast, molecular markers, including polymorphisms in genes involved in the pharmacodynamics and pharmacokinetics of vincristine, displayed great potential as predictive markers of neuropathy incidence and severity. Furthermore, antifungal drugs, such as itraconazole and voriconazole, decrease the metabolism of vincristine and consequently lead to severe neuropathy when co-administered with vincristine, underscoring why fluconazole should be the antifungal drug of choice. Conclusion Reports from the 71 included studies clearly emphasize the lack of consistency in neuropathy assessment, grading systems, and reporting, making it difficult to interpret results between studies. Thus, truer clinical and molecular markers could emerge if the consistency of neuropathy detection and reporting increases by the use of conventional standardized neuropathy assessment tools and grading scales. Electronic supplementary material The online version of this article (10.1007/s00280-019-03884-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review

Madsen

Due

Ejskjær

et al. 2019

Cancer Chemother Pharmacol

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“…However, in Watkins' series, the rate of neuropathy was lower. In this study on adult patients with lymphoma treated with vincristine (0.14 mg/kg), neuropathy was detected in 61% of the cases [10]. One of probable causes of difference in reports about neuropathy is that the prevalence and severity is individualspecific.…”

Section: Discussionmentioning

confidence: 69%

Electrophysiological consequences of vincristine contained chemotherapy in children: A cohort study

et al. 2015

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Vincristine is commonly used in treatment of acute lymphoblastic leukemia (ALL), and peripheral neuropathy is its dose-related toxicity. Motor impairment, specifically muscle weakness is the most severe manifestation of neuropathy. This study aimed at evaluation of the electrophysiological consequences of vincristine-contained chemotherapy in children. In a prospective cohort setting, the electrophysiological studies was performed in 42 children (25 cases of ALL, 17 cases of non-ALL malignancies) at the electrodiagnostic ward of Tabriz Children Hospital, before and five weeks after chemotherapy. Changes in the electrodiagnostic parameters before and after administration of vincristine, as well as its relation with drug dose were determined. Twenty-five children with ALL with the mean age of 6.08 years, and 17 children with other malignancies with the mean age of 6.54 years during a 12-months period were enrolled. In the ALL group, there was no significant change in motor and sensory nerve conduction velocity and amplitude of sensory nerve action potential after five weeks. However, the amplitude of compound muscle action potential (CMAP) was significantly decreased both in upper and lower extremities. Decreased CMAP amplitude was detected in 96% of the ALL cases after induction, majority moderate (70.8%). Sixteen (66.7%) patients suffered from gait abnormality as well. In the non-ALL group, five (29.4%) cases were treated with regimen similar to that employed in the ALL group (group B) and 12 (70.6%) patients were treated with other regimens (group C). Neuropathy was detected in nine (52.9%) patients, five (100%) cases in group B and four (33.3%) cases in group C. In group B, mild, moderate and severe neuropathies were detected in one (20%), three (60%) and one (20%) cases, respectively. Patients in group C were affected with mild neuropathy. Generally, there was a significant decrease of CMAP amplitude with increasing dose of vincristine. This study showed that the electrophysiological changes due to weekly administration of vincristine are common in children with ALL during the induction phase, which usually presented in the form of decreased CMAP amplitude (motor-axonal neuropathy), however routine sensory studies were normal. Gait abnormality is accompanied in 66.7% of ALL cases.

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“…These findings may arise from autonomic damage to the colon. Toxic effects are dose related and can be influenced by advancing age, concomitant liver damage, and type of malignancy [4].…”

Section: Discussionmentioning

confidence: 99%