在急性淋巴细胞白血病中因温克里斯诱导的神经毒性:综合系统性审查
H Shafeeq Ahmed1, Leroy D'Souza1, Diya Suhas1
1Bangalore Medical College and Research Institute, K.R Road, Bangalore, Karnataka 560002 India.
概括
文克里斯 (VCR) 可以在急性淋巴细胞白血病 (ALL) 患者中引起神经毒性,特别是在更高剂量或某些遗传因素的情况下. 管理涉及剂量改变和支持性护理,但需要更好的检测和策略.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性淋巴细胞白血病 (ALL) 是一种常见的儿童癌症.
- 文克里斯 (VCR) 是对ALL的重要化疗药物.
- 视频录像机可以引起显著的神经毒性,影响治疗和患者的结果.
研究的目的:
- 在ALL患者中审查风险因素,临床特征和VCR诱导的神经毒性的管理.
- 从系统的文献搜索中综合了目前关于VCR神经毒性的证据.
- 确定应对这一不利影响的挑战和未来方向.
主要方法:
- 使用PubMed,Scopus和CINAHL Ultimate进行系统的文献搜索.
- 包括对接受VCR治疗的ALL患者和报告神经毒性的研究.
- 遵守PRISMA系统审查指南.
主要成果:
- 包括109项研究,确定外围神经病变,神经问题和自主功能障碍是关键的神经毒性.
- 较高的累积VCR剂量 (>25 mg/m2),年龄较大,特定的遗传多态 (CEP72,ABCB1) 和同时使用甲状腺素增加了风险.
- 常见的症状包括感觉丧失,运动缺陷和胃肠道自主性问题,如便秘和腹.
结论:
- 由VCR诱导的神经毒性是ALL治疗的一个主要挑战.
- 目前的治疗包括剂量调整和症状治疗,但疗效不一致.
- 用标准化评估工具和前性研究进行进一步的研究对于早期检测和优化管理至关重要.
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