Effect of pyridoxine plus pyridostigmine treatment on vincristine-induced peripheral neuropathy in pediatric patients with acute lymphoblastic leukemia: a single-center experience

Effect of pyridoxine plus pyridostigmine treatment on vincristine-induced peripheral neuropathy in pediatric patients with acute lymphoblastic leukemia: a single-center experience

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 effectivene...

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Bibliographic Details
Published in:Neurological sciences Vol. 42; no. 9; pp. 3681 - 3686
Main Authors: Aydin Köker, Sultan, Gözmen, Salih, Demirağ, Bengü, Ünalp, Aycan, Karapinar, Tuba Hilkay, Oymak, Yeşim, Gürbüz, Gürkan, Öner, Ecem İpek, Vergin, Raziye Canan
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01-09-2021
Springer Nature B.V
Subjects:
Acute lymphoblastic leukemia
Chemotherapy
Diagnosis
Leukemia
Lymphatic leukemia
Medicine
Medicine & Public Health
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Neurotoxicity
Original Article
Patients
Pediatrics
Peripheral neuropathy
Psychiatry
Pyridostigmine
Pyridoxine
Risk groups
Vincristine
Acute lymphoblastic leukemia
Children pyridoxine plus pyridostigmine treatment
Vincristine-induced neuropathy
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Summary: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/m 2 . 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.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-020-04970-w