Mild axonal neuropathy of children during treatment for acute lymphoblastic leukaemia.
Neurophysiological functioning was studied prospectively in children treated for acute lymphoblastic leukaemia with a low dose vincristine regime (8 x 1.5 mg/m2/dose), to obtain more insight into vincristine neuropathy. A WHO neurotoxicity score was estimated and vibration sense and electrophysiological measurements were taken at standardized times during vincristine treatment. The WHO neurotoxicity score showed decreased or disappearance of Achilles tendon reflexes, and mild sensory disturbances, but a grade 3-4 neurotoxicity was not demonstrated by any of the children. Vibration perception thresholds increased progressively during treatment and amplitudes of action potentials of peroneal and sensory ulnar and median nerves decreased, whereas nerve conduction velocities stayed unchanged. Both vibration perception thresholds and the electrophysiological findings hardly exceeded the limits of normality. We conclude that children treated for acute lymphoblastic leukaemia with a low dose vincristine regimen have mild axonal neuropathy which may be responsible for the motor problems in these children.
Reinders-Messelink
H A
HA
Children's Cancer Center Groningen, University of Groningen, The Netherlands.
Van Weerden
T W
TW
Fock
J M
JM
Gidding
C E
CE
Vingerhoets
H M
HM
Schoemaker
M M
MM
Göeken
L N
LN
Bökkerink
J P
JP
Kamps
W A
WA
D000125:Achilles Tendon; D000200:Action Potentials / Q000187:drug effects; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001369:Axons / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000187:drug effects; D011115:Polyneuropathies / Q000139:chemically induced* / Q000503:physiopathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D011446:Prospective Studies; D012026:Reflex, Stretch / Q000187:drug effects; D012044:Regression Analysis; D012684:Sensory Thresholds / Q000187:drug effects; D014732:Vibration; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects*
D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine