Vincristine-induced urinary bladder paralysis

Area of Science:

• Pediatric Oncology
• Neuro-oncology
• Pharmacology

Background:

• Acute lymphoblastic leukemia (ALL) treatment involves complex chemotherapy regimens.
• Maintenance chemotherapy aims to prevent leukemia relapse.
• Certain chemotherapeutic agents can cause significant adverse effects.

Observation:

• A child with ALL developed reversible bladder paralysis during maintenance chemotherapy.
• The event occurred after intravenous vincristine and intrathecal chemotherapy (hydrocortisone, cytosine arabinoside, methotrexate), plus a prednisolone pulse.
• The child's symptoms resolved after vincristine was stopped.

Findings:

• The authors attribute the bladder paralysis to vincristine administration.
• This adverse event was reversible upon discontinuation of vincristine.
• Vincristine was omitted until the child fully recovered.

Implications:

• Clinicians should be aware of vincristine-induced neurotoxicity, specifically bladder paralysis, in pediatric ALL patients.
• Prompt recognition and temporary cessation of vincristine are crucial for managing this side effect.
• Understanding and managing chemotherapy-induced neurotoxicity is vital for maintaining treatment adherence and quality of life in children with ALL.