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Supportive Care in Cancer

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Open Access 01-05-2024 | Research

Characterising vincristine-induced peripheral neuropathy in adults: symptom development and long-term persistent outcomes

Authors: Tiffany Li, Terry Trinh, Annmarie Bosco, Matthew C. Kiernan, David Goldstein, Susanna B. Park

Published in: Supportive Care in Cancer | Issue 5/2024

Abstract

Background

Decades following the introduction of vincristine as treatment for haematological malignancies, vincristine-induced peripheral neuropathy (VIPN) remains a pervasive, untreatable side-effect. However there remains a gap in understanding the characteristics of VIPN in adults. This study presents a comprehensive phenotyping of VIPN.

Methods

Adult patients (n = 57; age = 59.8 ± 14.6) were assessed cross-sectionally following completion of vincristine (months post treatment = 16.3 ± 15.6, cumulative dose = 7.6 ± 4.4), with a subset of 20 patients assessed prospectively during treatment. Patient reported measures (EORTC-QLQ-CIPN20, R-ODS) were used to profile symptoms and disability. Neurological assessment was undertaken using the Total Neuropathy Score and nerve conduction studies. Sensory threshold and fine motor tasks were also undertaken. Comparisons of data between timepoints were calculated using paired-sample t tests or Wilcoxon matched-pairs signed-rank test. Comparisons between outcome measures were calculated with independent sample t tests or Mann–Whitney U tests for non-parametric data.

Results

The majority of patients developed VIPN by mid-treatment (77.8%, 7.0 ± 3.3 weeks post baseline) with the prevalence remaining stable by end-of-treatment (75%, 8.1 ± 1.7 weeks post mid-treatment). By 3 months post-completion, 50% of patients still reported VIPN although there were significant improvements on neurological grading and functional assessment (P < 0.05). VIPN presented with sensorimotor involvement in upper and lower limbs and was associated with decreased sensory and motor nerve amplitudes, reduced fine-motor function and increased disability.

Conclusion

VIPN in adults presents as a sensorimotor, upper- and lower-limb neuropathy that significantly impacts disability and function. Neuropathy recovery occurs in a proportion of patients; however, VIPN symptoms may persist and continue to affect long-term quality of life.

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Title: Characterising vincristine-induced peripheral neuropathy in adults: symptom development and long-term persistent outcomes
Authors: Tiffany Li
Terry Trinh
Annmarie Bosco
Matthew C. Kiernan
David Goldstein
Susanna B. Park
Publication date: 01-05-2024
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 5/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-024-08484-5

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