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Chemotherapy-induced Peripheral Neuropathy Among Paediatric Oncology Patients

Published online by Cambridge University Press:  20 October 2014

M.J. Purser ,
D.L. Johnston  and
H.J. McMillan
M.J. Purser
Affiliation:
University of Ottawa, Ottawa, Ontario, Canada
D.L. Johnston
Affiliation:
University of Ottawa, Ottawa, Ontario, Canada Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
H.J. McMillan*
Affiliation:
University of Ottawa, Ottawa, Ontario, Canada Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
*
Division of Neurology, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada. Email: hmcmillan@cheo.on.ca.
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Abstract

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Background:

Vinca alkaloids and platinum-containing chemotherapeutic drugs have the potential to cause chemotherapy-induced peripheral neuropathy (CIPN). This study determined the frequency of CIPN among children who were treated for acute lymphoblastic leukemia (ALL), lymphoma, brain tumour or Wilms tumour.

Procedure:

This retrospective cohort study reviewed 252 patients treated at the Children's hospital of Eastern Ontario from 2001-2011. Patients were considered to have CIPN if they developed clinical symptoms of CIPN such as limb paraesthesia, weakness and/or ataxia during chemotherapy and their treating neurologist or oncologist deemed that their symptoms were due to a peripheral cause. Patients were excluded if their treatment regime did not include chemotherapy.

Results:

The overall frequency of CIPN was 18.3% (46/252). Tumour-specific CIPN rates were: 18.9% (29/154) for ALL; 9.4% (3/32) for lymphoma; 17.9% (5/28) for Wilms tumour; and 23.7% (9/38) for brain tumour patients. Nerve conduction studies were completed for 17% of patients (all tumour types) and were abnormal in all but one patient. Among surviving CIPN patients (41/46), 93% showed no clinical deficits at their last examination, which was on average 56 months from time of diagnosis to last follow-up visit.

Conclusions:

The frequency of CIPN was less than that previously reported in adults receiving chemotherapy. Children with CIPN have a favourable outcome with most showing clinical improvement during the maintenance phase of treatment or after chemotherapy completion.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 4 , July 2014 , pp. 442 - 447
Copyright
Copyright © The Canadian Journal of Neurological 2014

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