title: Intraepidermal nerve fibre density in cancer patients receiving adjuvant chemotherapy.
abstract: BACKGROUND
  Chemotherapy-induced neuropathy is a common adverse event in patients receiving vinca alcaloids, platinum derivatives and taxanes. However, the underlying pathogenetic mechanisms have not been completely elucidated. We set up a prospective pilot study on skin biopsies in newly diagnosed cancer patients receiving neurotoxic chemotherapeutic agents as adjuvant treatment in order to study the occurrence of small-fibre pathology and its relationship to clinical symptoms.
  
  
  METHODS
  Skin biopsies from distal leg were performed in 12 patients before, during and after chemotherapy. Using light microscopy, the intraepidermal nerve fibre (IENF) density was determined from the skin biopsies by counting morphometrically the immunopositive nerves per epidermal area.
  
  
  RESULTS
  Reduced IENF density was observed in eight patients at baseline. During the follow-up, the IENF density increased significantly in six patients and remained unchanged in two. In four patients, the IENF density was normal both at baseline and at the end of the follow-up period. Neuropathic symptoms were manifested in nine patients, but no association with the IENF count was found.
  
  
  CONCLUSIONS
  During chemotherapy, results from patients revealed different evolutionary patterns of IENF density, but symptoms and IENF density were not related.
authors.affiliation: Department of Neurology, Tampere University Hospital, P.O.Box 2000, FIN-33521 Tampere, Finland. mika.koskinen@pshp.fi
authors.forename: Mika J
authors.initials: MJ
authors.lastname: Koskinen
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Kautio
authors.forename: Maija L
authors.initials: ML
authors.lastname: Haanpää
authors.forename: Hannu K
authors.initials: HK
authors.lastname: Haapasalo
authors.forename: Pirkko-L
authors.initials: PL
authors.lastname: Kellokumpu-Lehtinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Saarto
authors.forename: Aki J
authors.initials: AJ
authors.lastname: Hietaharju
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D000077143:Docetaxel; D004817:Epidermis / Q000187:drug effects / Q000294:innervation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009412:Nerve Fibers / Q000187:drug effects / Q000473:pathology*; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D010865:Pilot Projects; D011446:Prospective Studies; D012867:Skin / Q000187:drug effects / Q000294:innervation*; D043823:Taxoids / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D000077143:Docetaxel