Evaluation of neuropathy in patients on suramin treatment.
Suramin, a promising chemotherapeutic agent, causes a dose-limiting sensorimotor polyneuropathy. We undertook a phase 1 study of suramin that included serial neurologic and electrophysiologic examinations as part of the safety evaluation. We found that 6 of 41 (15%) patients developed suramin-induced demyelinating neuropathy which resembled Guillain-Barre syndrome clinically. There was 1 asymptomatic patient with electrophysiologic abnormalities suggestive of a demyelinating neuropathy. In addition, 1 patient with mild axonal neuropathy at baseline had deterioration of his symptoms during suramin treatment. Four asymptomatic patients developed electrophysiologic findings suggestive of a mild axonal neuropathy. We conclude that: (1) serial electrophysiologic monitoring is helpful for early detection of suramin-induced neuropathy; and (2) fixed dosing schedule of suramin without adaptive control does not lead to an increased incidence of demyelinating neuropathy when compared to adaptively controlled dosing schedules.
Soliven
B
B
Department of Neurology, Brain Research Institute, The University of Chicago, Illinois 60637, USA.
Dhand
U K
UK
Kobayashi
K
K
Arora
R
R
Martin
B
B
Petersen
M V
MV
Janisch
L
L
Vogelzang
N J
NJ
Vokes
E E
EE
Ratain
M J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003711:Demyelinating Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000139:chemically induced*; D009431:Neural Conduction / Q000502:physiology*; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D013498:Suramin / Q000009:adverse effects* / Q000627:therapeutic use
D013498:Suramin