Vincristine-induced Peripheral Neuropathy and Urinary Bladder Paralysis in a Child With Rhabdomyosarcoma

Çıtak, Elvan Çağlar; Oğuz, Aynur; Karadeniz, Ceyda; Karaoğlan, Belgin; Tan, Mustafa; Okur, Visal; Cansu, Ali

doi:10.1097/mph.0b013e318158343b

Cited by 15 publications

(7 citation statements)

References 11 publications

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“…7 The literature supporting VCR-induced bladder neuropathy is less robust; however, reports of suspected cases are published. 8,9 The clinical relevance of postchemotherapy LUTD manifests in the care of the pediatric cancer survivor. Recent decades have seen dramatic improvements in the 5-year survival rates of the most prevalent childhood cancers.…”

Section: Discussionmentioning

confidence: 99%

A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy

Hecht

Quach

Gao

et al. 2021

Pediatric Blood & Cancer

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Background Two chemotherapeutic agents used widely in pediatric oncology are vincristine (VCR) and doxorubicin (DOX), which may cause neuropathy and myopathy, respectively. The study hypothesis is that neurotoxic effects of VCR and/or myotoxic effects of DOX affect bladder physiology and manifest clinically as lower urinary tract dysfunction (LUTD). Procedure Based on a priori power analysis, 161 children divided evenly by gender were recruited. Children aged 5–10 years completed the dysfunctional voiding scoring system (DVSS) survey. The study cohort comprised cancer survivors treated with VCR and/or DOX. Healthy controls were recruited from well‐child clinic visits. Exclusion criteria included pelvic‐based malignancy, pelvic irradiation, pre‐existing LUTD, neurologic abnormalities, and treatment with cyclophosphamide/ifosfamide. DVSS scores and presence of LUTD, defined as DVSS scores above gender‐specific thresholds (males ≥9, females ≥6), were compared across cohorts. Results Median DVSS scores were higher in the study cohort (6 vs. 4, p = .003). Moreover, children in the study cohort were more likely to exceed threshold scores for LUTD (38.8% vs. 21%, p = .014; OR 1.8). Subanalysis by gender revealed female cancer survivors are more likely to report LUTD than controls (57.5% vs. 30%, p = .013, OR 1.9). This did not hold true for males (20% vs. 12.2%, p = .339). Conclusions Childhood cancer survivors who received VCR and/or DOX reported higher rates of LUTD than controls. Female cancer survivors appear more likely to suffer from LUTD than males. Further study with a positive control cohort of cancer survivors who received non‐VCR, non‐DOX chemotherapy is underway to elucidate the contribution of a cancer diagnosis to LUTD.

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Section: Discussionmentioning

confidence: 99%

A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy

Hecht

Quach

Gao

et al. 2021

Pediatric Blood & Cancer

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“…The novelty and significance of this study lie in the comprehensive description of all facets of vincristine-related NP: incidence, severity, and treatment; and in the exhaustive investigation of the associated risk factors, in the largest study to date in children treated for ALL. Previous studies of vincristine-induced neurotoxicity in children have been mainly case reports [10][11][12][13] and small series [14,15], and only race [16] and BMI [14] have been investigated as risk factors. We found that white non-Hispanic race is significantly predictive of vincristine-related NP, consistent with a previous study showing less neurotoxicity (4.8% versus 34.8%) and fewer reduced or missed vincristine doses in 21 black children than in 92 white non-Hispanic children with ALL [16].…”

Section: Discussionmentioning

confidence: 99%

Neuropathic pain during treatment for childhood acute lymphoblastic leukemia

Anghelescu

Faughnan

Jeha

et al. 2011

Pediatric Blood & Cancer

104

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“…VCR is an important part of many pediatric oncology treatment regimens; however, it is known to cause impairment of axonal transport, distal axonopathy and neuroinflammation, leading to VIPN 1 . Previously two clinical cases of the neurotoxic effects of VCR on LUT function; urinary bladder paralysis and detrusor areflexia, were reported 13 , 14 . In this study, the mice who received VCR demonstrated a decrease in micturition frequency and increased NVCs.…”

Section: Discussionmentioning

confidence: 99%

Sexual dimorphic impacts of systemic vincristine on lower urinary tract function

Iguchi

Hecht

Gao

et al. 2022

Sci Rep

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Vincristine (VCR) is one of the most common chemotherapy agents used in pediatric oncology. Despite the well-known VCR-induced peripheral neuropathy, potential impacts of VCR on lower urinary tract (LUT) function remain poorly defined. We investigated the effects of systemic VCR exposure in childhood on LUT function by using juvenile mice treated with VCR (4 mg/kg) or saline and evaluated at 5 weeks later. VCR induced a decreased urinary frequency with increased functional bladder capacity and non-void contractions. There were no changes in detrusor contractility between the groups. VCR exposure caused sexual dimorphic changes; in females, increased intravesical pressure at micturition and downregulations of a major player in bladder afferent firing, Htr3b, in the bladders, and Cav1.2 in the lumbosacral dorsal root ganglia (Ls-DRG), while male mice displayed increases in bladder compliance and detrusor activity, upregulations of IL-2, Trpa1 and Itga1 in the bladders and neuroinflammation-related genes, P2×4, P2×7, IL-2 and CD68 in the Ls-DRG. These results suggest that that systemic VCR exposure caused sensory neuropathy via sex-dimorphic mechanisms, leading to altered LUT function. These changes might clinically present as gender-specific signs or symptoms of LUT dysfunction, and follow-up urological assessment may be of benefit for pediatric cancer patients treated with VCR.

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Vincristine-induced Peripheral Neuropathy and Urinary Bladder Paralysis in a Child With Rhabdomyosarcoma

Cited by 15 publications

References 11 publications

A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy

A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy

Neuropathic pain during treatment for childhood acute lymphoblastic leukemia

Sexual dimorphic impacts of systemic vincristine on lower urinary tract function

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