| 제목 |
Quantitative analysis of Vincristine induced- peripheral neuropathy in children with ALL |
| 소속 |
Kyungpook National University Chilgok Hospital, Department of Rehabilitation Medicine1, Kyungpook National University Hospital, Department of Rehabilitation Medicine2 |
| 저자 |
Ju-Hyun Kim1*, Hyun-Min Oh2, Seung-Hwan Jung2, Hyun-Woo Jung1, Chul-Hyun Kim2, Tae-Du Jung1† |
Objective
Motor problems of children with acute lymphoblastic leukemia(ALL) after vincristine administration are frequently reported. This is thought to be vicristine-induced neuropathy, which has dose-related, length-dependent and axonal pattern. In particular, the weakness of lower extremities is seemed more apparent in children than in adults. In this study, we analyzed vincristine induced peripheral neuropathy in children quantitatively.
Methods
Electrodiagnostic examinations were conducted in 32 children who had been
treated with vincristine and showed signs of peripheral neuropathy.
Results
Electrodiagnostic examination showed an axonal neuropathy with a length-dependent pattern. Motor nerve abnormalities were observed in all 32 patients, and sensory neuropathy was accompanied in 12 of them(37.5%). The number of affected nerves was 3.31±0.85 (mean±SD) of four motor nerves, which was 0.78±1.18 in the sensory nerve. This difference between motor and sensory nerve was significant. Compared with pediatric reference value, the mean compound muscle action potential(CMAP) amplitude was 39.2±20.5% in the median nerve and 11.6±12.3% in the peroneal nerve. Meanwhile, sensory nerve action potential of sensory nerve amplitude was 107.0±52.9% in the median nerve and 133.3±68.2% in the superficial peroneal nerve. There was statistically significant difference between amplitude of the compound muscle action potential and sensory nerve action potential.
Conclusions
Vincristine is well known neurotoxic agent used for treatment of leukemia, lymphomas and cancers. Its main side effect is a dose-related, length-dependent axonal neuropathy. Especially, motor predominance has been reported in children. In this study, we conducted electrodiagnostic examination and motor predominance neuropathy was shown due to incomplete myelination in children. |
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Table 1. Clinical characteristics of patients (N=32)
Table 2. Involvement pattern of nerve in Vincristine induced peripheral neuropathy in childhood
Table 3. Quantitative analysis of CMAP and SNAP amplitude in motor and sensory nerve in Vincristine induced peripheral neuropathy in childhood ALL
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