Mild axonal neuropathy of children during treatment for acute lymphoblastic leukaemia.

H A Reinders-Messelink, T W Van Weerden, J M Fock, C E Gidding, H M Vingerhoets, M M Schoemaker, L N Göeken, J P Bökkerink, W A Kamps

Journal: European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society 2001;4(5):225-33

PMID: 11030069

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Abstract

Neurophysiological functioning was studied prospectively in children treated for acute lymphoblastic leukaemia with a low dose vincristine regime (8 x 1.5 mg/m2/dose), to obtain more insight into vincristine neuropathy. A WHO neurotoxicity score was estimated and vibration sense and electrophysiological measurements were taken at standardized times during vincristine treatment. The WHO neurotoxicity score showed decreased or disappearance of Achilles tendon reflexes, and mild sensory disturbances, but a grade 3-4 neurotoxicity was not demonstrated by any of the children. Vibration perception thresholds increased progressively during treatment and amplitudes of action potentials of peroneal and sensory ulnar and median nerves decreased, whereas nerve conduction velocities stayed unchanged. Both vibration perception thresholds and the electrophysiological findings hardly exceeded the limits of normality. We conclude that children treated for acute lymphoblastic leukaemia with a low dose vincristine regimen have mild axonal neuropathy which may be responsible for the motor problems in these children.

Address: Children's Cancer Center Groningen, University of Groningen, The Netherlands.

DOI: 10.1053/ejpn.1999.0310

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MeSH Terms: Achilles Tendon, Action Potentials, Antineoplastic Agents, Phytogenic, Antineoplastic Combined Chemotherapy Protocols, Axons, Child, Child, Preschool, Dose-Response Relationship, Drug, Female, Humans, Male, Neural Conduction, Polyneuropathies, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Prospective Studies, Reflex, Stretch, Regression Analysis, Sensory Thresholds, Vibration, Vincristine