Severe Neurotoxicities in a Case of CMT 2 caused by Vincristine for Acute Lyphob

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Severe Neurotoxicities in a Case of Charcot-Marie-Tooth Disease Type

2 Caused by Vincristine for Acute Lymphoblastic Leukemia.

Journal of Pediatric Hematology/Oncology. 30(7):519-521, July 2008.

http://www.jpho-online.com

Nishikawa, Takuro MD *; Kawakami, Kiyoshi MD *; Kumamoto, Takashi MD

*; Tonooka, Shiro MD *; Abe, Akiko MD +; Hayasaka, Kiyoshi MD +;

Okamoto, Yasuhiro MD ++; Kawano, Yoshifumi MD ++

We report a 13-year-old male patient with Charcot-Marie-Tooth disease

(CMT) type 2 who developed severe neuropathy because of vincristine

(VCR) for his acute lymphoblastic leukemia. A clumsy gait, muscle

weakness in his fingers, and inverted champagne bottlelike muscle in

the lower limbs were noticed after remission induction treatment for

acute lymphoblastic leukemia, which included VCR at a total dose of 8

mg/m2.

An electrophysiologic study showed an almost normal median motor

nerve conduction velocity (approximately 50 m/s), markedly reduced M-

wave amplitude and sensory disturbance. He was diagnosed as CMT type

2 based on his symptoms and electrophysiologic findings. His symptoms

gradually worsened, and even after VCR was discontinued, he could not

walk alone for 7 months.

VCR has previously been considered to be relatively safe in CMT type

2, however, some patients with CMT type 2 might show severe

neurologic toxicities, as seen in patients with CMT type 1.