Background

Vincristine (VCR), which is a key component of chemotherapy, is important for survival. VCR is associated with a well-known side effect, including neurotoxicity.

Aims

The aim of this study was to evaluate the features of vincristine-induced peripheral neuropathy (VIPN) and the effectiveness of pyridoxine plus pyridostigmine therapy in children with acute lymphoblastic leukemia.

Methods

The WHO and NCI CTCAE neurotoxicity scorings were used to evaluate VIPN at diagnosis, in the first month, and after the third month of the treatment. The clinical features of 23 patients having acute lymphoblastic leukemia with VIPN during the period of July 2013–February 2016 were prospectively evaluated.

Results

The mean age was 72.8 ± 51.6 months, and 26.1%, 56.5%, and 17.4% were in standard, moderate, and high-risk groups, respectively. Neuropathy frequently occurred at induction (82.6%) and reinduction (17.4%) of the protocol. Drop foot (82.6%), leg pain (82.6%), and difficulty in walking (82.6%) were observed. The mean total cumulative dose of neuropathy occurrence was 5.6 ± 2.03 mg/m². Our study showed that both the WHO and NCI CTCAE scorings were significantly improved via pyridoxine plus pyridostigmine therapy.

Conclusion

The WHO and NCI CTCAE scorings may be used for evaluating neuropathy at diagnosis and follow-up of neurotoxicity with treatment. Pyridoxine plus pyridostigmine therapy may be an effective option in the treatment of VIPN.

中文翻译：

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吡哆醇加吡啶斯的明治疗小儿急性淋巴细胞白血病患者长春新碱引起的周围神经病变的影响：单中心经验

背景

长春新碱 (VCR) 是化疗的关键成分，对生存很重要。VCR 与众所周知的副作用有关，包括神经毒性。

宗旨

本研究的目的是评估长春新碱引起的周围神经病变 (VIPN) 的特征以及吡哆醇加吡啶斯的明治疗儿童急性淋巴细胞白血病的有效性。

方法

WHO 和 NCI CTCAE 神经毒性评分用于评估诊断时、治疗第一个月和第三个月后的 VIPN。前瞻性评估了2013年7月至2016年2月期间23例患有VIPN的急性淋巴细胞白血病患者的临床特征。

结果

平均年龄为 72.8 ± 51.6 个月，标准、中度和高危组分别占 26.1%、56.5% 和 17.4%。神经病变经常发生在方案的诱导 (82.6%) 和再诱导 (17.4%)。观察到足下垂 (82.6%)、腿痛 (82.6%) 和行走困难 (82.6%)。发生神经病变的平均总累积剂量为 5.6 ± 2.03 mg/m ²。我们的研究表明，通过吡哆醇加吡啶斯的明治疗，WHO 和 NCI CTCAE 评分均显着提高。

结论

WHO 和 NCI CTCAE 评分可用于评估神经病变的诊断和治疗后的神经毒性随访。吡哆醇加吡啶斯的明治疗可能是治疗VIPN的有效选择。