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Effect of pyridoxine plus pyridostigmine treatment on vincristine-induced peripheral neuropathy in pediatric patients with acute lymphoblastic leukemia: a single-center experience

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Abstract

Background

Vincristine (VCR), which is a key component of chemotherapy, is important for survival. VCR is associated with a well-known side effect, including neurotoxicity.

Aims

The aim of this study was to evaluate the features of vincristine-induced peripheral neuropathy (VIPN) and the effectiveness of pyridoxine plus pyridostigmine therapy in children with acute lymphoblastic leukemia.

Methods

The WHO and NCI CTCAE neurotoxicity scorings were used to evaluate VIPN at diagnosis, in the first month, and after the third month of the treatment. The clinical features of 23 patients having acute lymphoblastic leukemia with VIPN during the period of July 2013–February 2016 were prospectively evaluated.

Results

The mean age was 72.8 ± 51.6 months, and 26.1%, 56.5%, and 17.4% were in standard, moderate, and high-risk groups, respectively. Neuropathy frequently occurred at induction (82.6%) and reinduction (17.4%) of the protocol. Drop foot (82.6%), leg pain (82.6%), and difficulty in walking (82.6%) were observed. The mean total cumulative dose of neuropathy occurrence was 5.6 ± 2.03 mg/m2. Our study showed that both the WHO and NCI CTCAE scorings were significantly improved via pyridoxine plus pyridostigmine therapy.

Conclusion

The WHO and NCI CTCAE scorings may be used for evaluating neuropathy at diagnosis and follow-up of neurotoxicity with treatment. Pyridoxine plus pyridostigmine therapy may be an effective option in the treatment of VIPN.

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Authors and Affiliations

  1. Department of Pediatric Hematology and Oncology, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Sultan Aydin Köker, Salih Gözmen, Bengü Demirağ, Tuba Hilkay Karapinar, Yeşim Oymak & Raziye Canan Vergin

  2. Department of Pediatric Neurology, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Aycan Ünalp & Gürkan Gürbüz

  3. Department of Pediatrics, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Ecem İpek Öner

Authors
  1. Sultan Aydin Köker
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  2. Salih Gözmen
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  3. Bengü Demirağ
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  4. Aycan Ünalp
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  5. Tuba Hilkay Karapinar
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  6. Yeşim Oymak
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  8. Ecem İpek Öner
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  9. Raziye Canan Vergin
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Correspondence to Sultan Aydin Köker.

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The authors declare that they have no conflicts of interest.

Ethical approval

Ethics committee approval was obtained from Dr. Behçet Uz Children's hospital on 24.12.2015 (protocol number:2015/51).

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Aydin Köker, S., Gözmen, S., Demirağ, B. et al. Effect of pyridoxine plus pyridostigmine treatment on vincristine-induced peripheral neuropathy in pediatric patients with acute lymphoblastic leukemia: a single-center experience. Neurol Sci 42, 3681–3686 (2021). https://doi.org/10.1007/s10072-020-04970-w

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  • DOI: https://doi.org/10.1007/s10072-020-04970-w

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