title: Measuring vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia.
abstract: BACKGROUND
  Vincristine-induced peripheral neuropathy (VIPN) is difficult to quantify in children.
  
  
  OBJECTIVE
  The study objective was to examine the reliability, validity, and clinical feasibility of several VIPN measures for use in children with acute lymphoblastic leukemia.
  
  
  METHODS
  Children (n = 65) aged 1 to 18 years receiving vincristine at 4 academic centers participated in the study. Baseline and pre-vincristine administration VIPN assessments were obtained using the Total Neuropathy Score-Pediatric Vincristine (TNS©-PV), the National Cancer Institute Common Terminology Criteria for Adverse Events, the Balis grading scale, and the FACES Pain Scale. The TNS-PV scores (n = 806) were obtained over 15 weeks. Blood was obtained at several time points to quantify pharmacokinetic parameters.
  
  
  RESULTS
  Cronbach's α for a reduced TNS-PV scale was .84. The TNS-PV scores correlated with cumulative vincristine dosage (r = 0.53, P = 0.01), pharmacokinetic parameters (r = 0.41, P = 0.05), and grading scale scores (r range = 0.46-0.52, P = .01). FACES scores correlated with the TNS-PV neuropathic pain item (r = 0.48; P = .01) and were attainable in all ages. A 2-item V-Rex score (vibration and reflex items) was the most responsive to change (effect size = 0.65, P < 0.001). The TNS-PV scores were attainable in 95% of children 6 years or older.
  
  
  CONCLUSIONS
  The TNS-PV is reliable and valid for measuring VIPN. It is sensitive to change over time (15 weeks) and feasible for use in children 6 years or older.
  
  
  CONCLUSIONS
  The TNS-PV may be a useful tool for assessing vincristine toxicity in children with acute lymphoblastic leukemia.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA. ellenls@umich.edu
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Lavoie Smith
authors.forename: Lang
authors.initials: L
authors.lastname: Li
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Hutchinson
authors.forename: Richard
authors.initials: R
authors.lastname: Ho
authors.forename: W Bryan
authors.initials: WB
authors.lastname: Burnette
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wells
authors.forename: Celia
authors.initials: C
authors.lastname: Bridges
authors.forename: Jamie
authors.initials: J
authors.lastname: Renbarger
mesh_terms: D000293:Adolescent; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009730:Nursing Assessment; D010147:Pain Measurement / Q000451:nursing*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000451:nursing*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000451:nursing*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014018:Tissue Distribution; D014481:United States; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine