Total Neuropathy Scale Pediatric Vincristine to detect vincristine induced peripheral neuropathy in children with Acute Lymphoblastic Leukemia | [Rawal Medical Journal • 2023]

Author(s):

1. Prastiya Indra Gunawan: Department of Child Health, Soetomo General Hospital,Surabaya,Indonesia

2. Kartika Hardiyani: Department of Child Health, Soetomo General Hospital,Surabaya,Indonesia

3. I Dewa Gede Ugrasena: Department of Child Health, Soetomo General Hospital,Surabaya,Indonesia

Abstract:

Objective: To analyze the Total Neuropathy Scale Pediatric Vincristine (TNS-PV) score as a vincristine induced peripheral neuropathy (VIPN) diagnostic tool. Methodology: This observational analytic study was conducted in Outpatient Pediatric Hematology Oncology Dr. Soetomo Hospital. The inclusion criteria were Acute Lymphoblastic Leukemia (ALL) children aged 4 - 18 years that had undergone chemotherapy treatment, received a cumulative dose of vincristine > 12 mg/m2, had no muscle weakness and signed informed consent. The TNS-PV instrument were used to assess VIPN and nerve conduction studies (NCS) was used as the gold standard. Results: A total of 54 children were enrolled, two refused to sign the informed consent. About 60% were male children, 76.9% aged < 10 years old, and 94% were ALL-L1. The TNS-PV had an area under the curve (AUC) of 0.638 (95% CI 0.531-0.834) with cut off value of 3.5. It had a sensitivity 87.9%; specificity 42.1%, positive predictive value 72.5%; negative predictive value (NPV) 66.6% and OR (Odds ratio) 5,273. Conclusion: TNS-PV score cannot replace NCS as the gold standard, but TNS-PV can be an alternative tool for diagnosing VIPN.

Page(s): 179-184

DOI: DOI not available

Published: Journal: Rawal Medical Journal, Volume: 48, Issue: 1, Year: 2023

Keywords:

Acute Lymphoblastic Leukemia , vincristine induced peripheral neuropathy , total neuropathy scale pediatric vincristine

References:

[1] Bhojwani D,Yang JJ,Pui CH .2015 .Biology of childhood acute lymphoblastic leukemia. Pediatr Clin North Am, 62 : 47-60.

[2] Smith EML,Li L,Chiang C,Thomas K,Hutchinson RJ,Wells EM .2015 .Patterns and severity of vincristineinduced peripheral neuropathy in children with acute lymphoblastic leukemia. J Peripher Nerv Syst, 20 : 37-46.

[3] Pachman DR,Barton DL,Watson JC,Loprinzi CL .2011 .Chemotherapy-induced peripheral neuropathy: Prevention and treatment. Clin Pharmacol Ther, 90 : 377-87.

[4] Tunjungsari DA,Gunawan PI,Ugrasena IDG .2021 .Risk factors of vincristine-induced peripheral neuropathy in acute lymph blastic leukaemia children. JMI, 68 : 232-7.

[5] Ness KK,Jones KE,Smith WA,Spunt SL,Wilson CL,Armstrong GT .2013 .Chemotherapy-related neuropathic symptoms and functional impairment in adult survivors of extracranial solid tumors of childhood: results from the St Jude Lifetime Cohort study. Arch Phys Med Rehabil, 94 : 1451-7.

[6] Postma TJ,Benard BA,Huijgens PC .1993 .Ossenkoppele, GJ Heimans JJ. Long-term effects of vincristine on the peripheral nervous system. J Neurooncol, 15 : 23-7.

[7] Kandula T,Park SB,Cohn RJ,Krishnan A V,Farrar MA .2016 .Pediatric chemotherapy induced peripheral neuropathy: A systematic review of current knowledge. Cancer Treat Rev, 50 : 118-28.

[8] Loprinzi P,Edwards M,Frith E. .2017 .Potential avenues for exercise to activate episodic memory-related pathway: A narrative review. Eur J Neurosci, 46 : 2066-77.

[9] Smolik S,Arland L,Hensley MA,Schissel D,Shepperd B,Thomas K .2018 .Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children's Oncology Group. J Pediatr Oncol Nurs, 35 : 267-75.

[10] Ceppi F,Langlois-Pelletier C,Gagné V,Rousseau J,Ciolino C,Lorenzo S De C .2014 .Polymorphisms of the vincristine pathway and response to treatment in children with childhood acute lymphoblastic leukemia. Pharmacogenomics, 15 : 1105-16.

[11] Diouf B,Crews KR,Lew G,Pei D,Cheng C,Bao J .2015 .Association of an inherited genetic variant with vincristine- related peripheral neuropathy in children with acute lymphoblast. Leukemia, 313 : 815-23.

[12] Tay CG,Lee VWM,Ong LC,Goh KJ,Ariffin H,Fong CY .2017 .Vincristine-induced peripheral neuropathy in survivors of childhood acute lymphoblastic leukaemia. Pediatr Blood Cancer, 64 : 1-7.

[13] Atkinson HC,Marsh JA,Rath SR,Kotecha RS,Gough H,Taylor M H .2015 .Increased Body Mass Index during Therapy for Childhood Acute Lymphoblastic Leukemia: A Significant and Underestimated Complication. Int J Pediatr, 23 : 1-10.

[14] Aytac S,Yetgin S,Tavil B .2006 .Acute and long-term neurologic complications in children with acute lymphoblastic leukemia. Turkish J Pediatr, 48 : 1-7.

[15] Casey EB,Jellife AM,Le Quesne PM,Millett YL .1973 .Vincristine neuropathy. Clinical and electrophysiological observations. Brain, 96 : 69-86.

[16] Toopchizadeh V,Barzegar M,Rezamand A,Feiz AH .2009 .Electrophysiological consequences of vincristine contained chemotherapy in children: a cohort study. J Pediatr Neurol, 7 : 351-6.

[17] Courtemanche H,Magot A,Ollivier Y,Rialland F,Leclair-Visonneau L,Fayet G .2015 .Vincristine-induced neuropathy: Atypical electrophysiological patterns in children. Muscle Nerve, 52 : 981-5.

[18] Gunawan PI,Primayani D,Saharso D. .2016 .Cortical visual impairment in children with acute encephalitis syndrome. BJMS, 15 : 249-51.

[19] Brigo F,Balter R,Marradi P,Ferlisi M,Zaccaron A,Fiaschi A. .2012 .Vincristine- related neuropathy versus acute inflammatory demyelinating polyradiculoneuropathy in children with acute lymphoblastic leukemia. J Child Neurol, 27 : 867-74.

[20] Gilchrist LS,Tanner L .2013 .The pediatric-modified total neuropathy score: A reliable and valid measure of chemotherapy-induced peripheral neuropathy in children with non-CNS cancers. Support Care Cancer, 21 : 847-56.

[21] Min Y-S M-G .2017 .Characteristics of Peripheral Polyneuropathy after Chemotherapy in Pediatric Acute Lymphoblastic Leukemia. Clin Pediatr Hematol, 24 : 107-13.

[22] Yildiz F.G.,Temucin ÇM .2016 .Vincristine-induced neurotoxicity: electrophysiological features in children. Neurol Res, 38 : 124-9.

[23] Madsen ML,Due H,Ejskjaer N,Jensen P,Madsen J,Dybkaer K. .2019 .Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review. Cancer Chemother Pharmacol, 84 : 471-85.

[24] Jain P,Gulati S,Seth R,Bakhshi S,Toteja GS,Pandey RM .2014 .Vincristine-induced neuropathy in childhood all (acute lymphoblastic leukemia) survivors: Prevalence and electrophysiological characteristics. J Child Neurol, 29 : 932-7.

Citations

Downloads

Views