AbstractBackgroundChildren with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children’s Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group.MethodsAALL0932 standard-B-ALL patients aged 3 years and older were evaluated at T1-T4 (end consolidation, maintenance month 1, maintenance month 18, 12 months posttherapy). Physical and occupational therapists (PT/OT) measured motor CIPN (hand and ankle strength, dorsiflexion and plantarflexion range of motion), sensory CIPN (finger and toe vibration and touch), function (dexterity [Purdue Pegboard], and walking efficiency [Six-Minute Walk]). Proxy-reported function (Pediatric Outcome Data Collection Instrument) and quality of life (Pediatric Quality of Life Inventory) were assessed. Age- and sex-matched z scores and proportion impaired were measured longitudinally and compared between groups.ResultsConsent and data were obtained from 150 participants (mean age = 5.1 years [SD = 1.7], 48.7% female). Among participants with completed evaluations, 81.8% had CIPN at T1 (74.5% motor, 34.1% sensory). When examining severity of PT/OT outcomes, only handgrip strength (P < .001) and walking efficiency (P = .02) improved from T1-T4, and only dorsiflexion range of motion (46.7% vs 14.7%; P = .008) and handgrip strength (22.2% vs 37.1%; P = .03) differed in vincristine and dexamethasone every 4 weeks vs vincristine and dexamethasone 12 weeks at T4. Proxy-reported outcomes improved from T1 to T4 (P < .001), and most did not differ between groups.ConclusionsCIPN is prevalent early in B-ALL therapy and persists at least 12 months posttherapy. Most outcomes did not differ between treatment groups despite reduction in vincristine frequency. Children with B-ALL should be monitored for CIPN, even with reduced vincristine frequency.

中文翻译：

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尽管长春新碱减少治疗儿童 B 急性淋巴细胞白血病，化疗引起的周围神经病变仍持续存在

摘要背景患有 B 型急性淋巴细胞白血病 (B-ALL) 的儿童有发生化疗引起的周围神经病变 (CIPN) 的风险。儿童肿瘤学组 AALL0932 在国家癌症研究所标准 B-ALL (SR AR B-ALL) 的平均风险子集中随机减少长春新碱和地塞米松的用量（每 4 周对比维持期间每 12 周一次）。我们纵向测量了 CIPN、整体和治疗组。方法AALL0932 名 3 岁及以上的标准 B-ALL 患者在 T1-T4（巩固结束、维持第 1 个月、维持第 18 个月、治疗后 12 个月）进行评估。物理和职业治疗师 (PT/OT) 测量运动 CIPN（手和脚踝力量、背屈和跖屈运动范围）、感觉 CIPN（手指和脚趾振动和触觉）、功能（灵巧性 [Purdue Pegboard] 和行走效率 [6] -步行一分钟]）。评估代理报告功能（儿科结果数据收集仪器）和生活质量（儿科生活质量量表）。纵向测量年龄和性别匹配的 z 分数和受损比例，并在各组之间进行比较。结果获得了 150 名参与者的同意和数据（平均年龄 = 5.1 岁 [SD = 1.7]，48.7% 为女性）。在完成评估的参与者中，81.8% 的人在 T1 时患有 CIPN（74.5% 为运动性，34.1% 为感觉性）。在检查 PT/OT 结果的严重性时，从 T1-T4 起，仅握力 (P < .001) 和步行效率 (P = .02) 有所改善，并且仅背屈运动范围有所改善 (46.7% vs 14.7%；P = . T4 时，每 4 周一次的长春新碱和地塞米松与 12 周的长春新碱和地塞米松相比，008）和握力（22.2% vs 37.1%；P = .03）有所不同。代理报告的结果从 T1 到 T4 有所改善（P < .001），并且大多数组之间没有差异。结论CIPN 在 B-ALL 治疗早期普遍存在，并持续至少 12 个月。尽管长春新碱频率减少，但大多数结果在治疗组之间没有差异。即使长春新碱使用频率降低，患有 B-ALL 的儿童也应监测 CIPN。