Incidence of vincristine-induced neuropathy doesn’t seem like related to dietary deficiencies, in response to analysis printed in Pediatric Hematology and Oncology.
Vincristine, a vinca alkaloid chemotherapy drug, is usually used within the therapy of childhood acute lymphoblastic leukemia (ALL) however can result in chemotherapy-induced peripheral neuropathy, an vital dose-limiting toxicity. Nevertheless, little analysis has been carried out in sufferers with attainable concomitant dietary deficiencies.
Subsequently, researchers carried out a potential observational examine over a interval of two years at a youngsters’s hospital in India. They evaluated 30 youngsters with newly recognized ALL, 28 (93.three%) of whom had B-cell ALL and a pair of (6.7%) of whom had T-cell ALL. Vitamin B12, folate, and serum ferritin ranges have been measured for all sufferers.
Over four weeks of remark, medical peripheral neuropathy developed in 12 sufferers. Autonomic nervous system involvement was the commonest, however involvement of the sensory and motor methods occurred as properly. Electrophysiologic testing discovered that 15 sufferers (50%) had neuropathy.
Undernutrition, outlined utilizing standards from the World Well being Group, was recognized in 14 sufferers (46.7%). No distinction was present in incidence of vincristine-induced neuropathy between sufferers with undernutrition (7 sufferers) and sufferers with out undernutrition (eight sufferers). Moreover, the researchers discovered no correlation between presence of undernutrition and growth of neuropathy (P =1.zero). Ranges of vitamin B12, folate, and serum ferritin have been comparable in youngsters with and with out neuropathy.
The researchers concluded that though optimum nerve perform depends on a continuing provide of macronutrients and micronutrients, dietary deficiencies might not affect growth of neuropathy in Indian youngsters with ALL. Nevertheless, they acknowledged that their examine had some limitations, similar to the lack to measure expression of CYP3A5 (an enzyme answerable for vincristine metabolism) and serum albumin and the usage of ferritin to evaluate iron deficiency. They famous that additional analysis is warranted to guage the position of micronutrient deficiencies within the growth of vincristine-induced peripheral neuropathy in childhood ALL.
1. Dudeja S, Gupta S, Sharma S, et al. Incidence of vincristine induced neurotoxicity in children with acute lymphoblastic leukemia and its correlation with nutritional deficiencies [published online September 13, 2019]. Pediatr Hematol Oncol.