CMT1A: Low Dose Vincristine-induced Severe Polyneuropathy in a Hodgkin Lymphoma

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J Pediatr Hematol Oncol. 2009 Sep 18.

Low Dose Vincristine-induced Severe Polyneuropathy in a Hodgkin Lymphoma

Patient: A Case Report (Vincristine-induced Severe Polyneuropathy).

Cil T, Altintas A, Tamam Y, Battaloðlu E, Isikdogan A.

*Departments of *Medical Oncology daggerHematology, Internal Medicine Neurology,

Dicle University, Diyarbakir section Department of Molecular Biology and

Genetics, Bogazici University, Istanbul, Turkey.

Chemotherapeutic drugs are the most common toxic agents for peripheral nerves.

Vincristine is a vinca alkaloid drug that is used for the treatment of several

malignancies in combination with other chemotherapeutic agents.

Treatment with intravenous (IV) vincristine at doses above 5 mg leads to a

dose-dependent neuropathy with sensory symptoms but higher cumulative doses at

around 30 to 50 mg are needed for the development of motor symptoms. The

standard maximum adult IV vincristine dose is 2 mg IV per dose given at weekly

intervals.

However, administration of a single 2-mg dose IV vincristine may rarely result

in the development of peripheral neuropathy. Few case reports have been

presented on vincristine-associated severe paralysis in patients with

preexisting hereditary neuropathy like Charcot-Marie Tooth (CMT) disease, who

received doses even lower than 2 mg.

Herein, we reported a Hodgkin lymphoma patient who developed severe

polyneuropathy after receiving 2 mg vincristine treatment and was subsequently

found to carry the CMT1A duplication responsible for CMT disease.