title: Risk Factors for Early-Onset Peripheral Neuropathy Caused by Vincristine in Patients With a First Administration of R-CHOP or R-CHOP-Like Chemotherapy.
abstract: BACKGROUND
  Peripheral neuropathy is a well-known side effect of vincristine (VCR), a microtubule inhibitor used for R-CHOP or R-CHOP-like (namely R-CVP and R-THP-COP) regimens. Previous studies have shown that both the total dose of VCR and the number of treatment cycles are related to the incidence of VCR-induced peripheral neuropathy (VIPN). However, VIPN will also occur during the first treatment cycle regardless of the total dose of VCR or number of treatment cycles (early-onset VIPN). There is little information about early-onset VIPN, and it is difficult to predict. The present study's goal was to identify risk factors for early-onset VIPN.
  
  
  METHODS
  We analyzed the case records of patients who had their first administration of an R-CHOP or R-CHOP-like regimen between April 2008 and August 2013 at Tokushima University Hospital in Tokushima, Japan. To identify the risk factors for early-onset VIPN, we performed univariate and multivariate logistic regression analyses.
  
  
  RESULTS
  Forty-one patients underwent an R-CHOP or R-CHOP-like regimen for the first time at Tokushima University Hospital between April 2008 and August 2013, and 14 patients had grade 1 or higher early-onset VIPN. A univariate analysis revealed that age, the dose of VCR and the concomitant use of aprepitant appeared to be the risk factors of early-onset VIPN. In our calculation using receiver-operator characteristics curves, the cut-off value for patient age was 65 years and that of the dose of VCR was 1.9 mg. A multivariate analysis revealed that VCR dose ≥ 1.9 mg and the concomitant use of the antiemetic aprepitant were independent risk factors for early-onset VIPN.
  
  
  CONCLUSIONS
  Our present study showed that the patients who had VCR dose ≥ 1.9 mg and the concomitant use of aprepitant had the risk for early-onset VIPN. This suggests that it is important to use aprepitant in light of the risk of early-onset VIPN and the benefit of aprepitant's antiemetic effect in R-CHOP and R-CHOP-like regimens.
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Okada
authors.affiliation: Faculty of Pharmaceutical Sciences, University of Tokushima, Shomachi-1, Tokushima 770-8505, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hanafusa
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Sakurada
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Teraoka
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kujime
authors.affiliation: Department of Medicine and Bioregulatory Sciences, Graduate School of Medical Sciences, University of Tokushima, 3-8-15 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abe
authors.affiliation: Institute for Genome Research, University of Tokushima, 3 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shinohara
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan ; Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawazoe
authors.affiliation: Department of Pharmacy, Tokushima University Hospital, 2-50-1 Kuramoto, Tokushima 770-8503, Japan ; Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima, 2-50-1 Kuramoto, Tokushima 770-8503, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minakuchi
keywords: Aprepitant; Dose of vincristine; Early-onset peripheral neuropathy; Risk factor; Vincristine