Taxol neuropathy. Electrodiagnostic and sural nerve biopsy findings

Taxol has recently been approved for the treatment of ovarian cancer that has failed to respond to other chemotherapeutic agents. A predominantly sensory neuropathy has been reported in patients receiving taxol, but corresponding nerve changes have not been described. The patient described herein received taxol at a dose of 275 mg/m2 every 21 days. The sural nerve biopsy performed after 17 courses of taxol (cumulative dose, 6603 mg) showed severe nerve fiber loss, axonal atrophy, and secondary demyelination. Axonal regeneration was absent. The findings are compatible with a cell body disease or a length-dependent, distal neuropathy with failure of axonal regeneration. The findings observed in taxol-induced neuropathy are important to document for comparison with other neoplastic and paraneoplastic neuropathies affecting patients with cancer.