title: Patterns and severity of vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia.
abstract: Vincristine, a critical component of combination chemotherapy treatment for pediatric acute lymphoblastic leukemia (ALL), can lead to vincristine-induced peripheral neuropathy (VIPN). Longitudinal VIPN assessments were obtained over 12 months from newly diagnosed children with ALL (N = 128) aged 1-18 years who received vincristine at one of four academic children's hospitals. VIPN assessments were obtained using the Total Neuropathy Score-Pediatric Vincristine (TNS©-PV), National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE©), Balis© grading scale, and Pediatric Neuropathic Pain Scale©-Five (PNPS©-5). Of children who provided a full TNS©-PV score, 85/109 (78%) developed VIPN (TNS©-PV ≥4). Mean TNS©-PV, grading scale, and pain scores were low. CTCAE©-derived grades 3 and 4 sensory and motor VIPN occurred in 1.6%/0%, and 1.9%/0% of subjects, respectively. VIPN did not resolve in months 8-12 despite decreasing dose density. VIPN was worse in older children. Partition cluster analysis revealed 2-3 patient clusters; one cluster (n = 14) experienced severe VIPN. In this population, VIPN occurs more commonly than previous research suggests, persists throughout the first year of treatment, and can be severe.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Lavoie Smith
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: Lang
authors.identifier: http://orcid.org/0000-0002-5334-8719
authors.initials: L
authors.lastname: Li
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: ChienWei
authors.initials: C
authors.lastname: Chiang
authors.affiliation: Department of Nursing, Children's Hospital Colorado, Aurora, CO, USA.
authors.forename: Karin
authors.initials: K
authors.lastname: Thomas
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Hutchinson
authors.affiliation: Children's National Health System, Washington, DC, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Wells
authors.affiliation: Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Ho
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: Jodi
authors.initials: J
authors.lastname: Skiles
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: Arindom
authors.initials: A
authors.lastname: Chakraborty
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Celia M
authors.initials: CM
authors.lastname: Bridges
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Renbarger
mesh_terms: D000293:Adolescent; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010147:Pain Measurement; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D012720:Severity of Illness Index; D014750:Vincristine / Q000009:adverse effects*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine
keywords: acute lymphoblastic leukemia; children; patterns; severity; vincristine-induced peripheral neuropathy