Experience with Vincristine - Associated Neurotoxicity
Objectives: To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity.
Design: A retrospective case series study
Setting: Burlingham Oncology Clinic, Nairobi.
Subjects: Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens.
Main outcome measures: The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2.
Results: Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV -positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine.
Conclusion: Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.