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Experience with vincristine--associated neurotoxicity
N A Othieno-Abinya1, L O Nyabola
1Department of Internal Medicine, Faculty of Medicine, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya.
Objectives:
To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity.
Design:
A retrospective case series study.
Setting:
Hurlingham Oncology Clinic, Nairobi.
Subjects:
Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens.
Main Outcome Measures:
The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2.
Results:
Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV-positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine.
Conclusion:
Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.