[Acute vincristine neurotoxicity in a non-Hodgkin's lymphoma patient with Charcot-Marie-Tooth disease].
A 44-year-old, previously healthy man with a diagnosis of non-Hodgkin's lymphoma (NHL, diffuse large B-cell type, stage IIA) was treated with combination chemotherapy including vincristine (VCR). After receiving a cumulative dose of VCR, he experienced rapid and marked weakening which progressed to quadriplegia and bulbar palsy. Prior to this therapy, the patient had no neurological problems, and his siblings were asymptomatic. Physical examination identified pes cavus (hollow foot), and electrodiagnostic studies showed markedly slower nerve conduction velocity of myelinated fibers, with abundant "onion bulb" formations. Chromosomal analysis detected 17p11.2-12 duplication, thus yielding a diagnosis of Charcot-Marie-Tooth (CMT) 1A. CMT disease is a familial neuromuscular disorder, and the incidence is approximately 1 in 2,500. We concluded that if CMT disease is diagnosed, vincristine should be avoided due to the potential severity of neurotoxicity to small doses.
Uno
S
S
Department of Hematology/Oncology, Jikei University Hospital.
Katayama
K
K
Dobashi
N
N
Hirano
A
A
Ogihara
A
A
Yamazaki
H
H
Usui
N
N
Kobayashi
T
T
Inoue
K
K
Kuraishi
Y
Y
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D010244:Bulbar Palsy, Progressive / Q000139:chemically induced*; D002607:Charcot-Marie-Tooth Disease / Q000150:complications*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011782:Quadriplegia / Q000139:chemically induced*; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects*
D014750:Vincristine