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Patterns and severity of vincristine‐induced peripheral neuropathy in children with acute lymphoblastic leukemia
Author(s) -
Lavoie Smith Ellen M.,
Li Lang,
Chiang ChienWei,
Thomas Karin,
Hutchinson Raymond J.,
Wells Elizabeth M.,
Ho Richard H.,
Skiles Jodi,
Chakraborty Arindom,
Bridges Celia M.,
Renbarger Jamie
Publication year - 2015
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/jns.12114
Subject(s) - medicine , vincristine , common terminology criteria for adverse events , peripheral neuropathy , pediatric cancer , lymphoblastic leukemia , neuropathic pain , pediatrics , adverse effect , grading (engineering) , chemotherapy , leukemia , cancer , anesthesia , cyclophosphamide , civil engineering , engineering , diabetes mellitus , endocrinology
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.