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Title

[Acute vincristine neurotoxicity in a non-Hodgkin's lymphoma patient with

Charcot-Marie-Tooth disease]

Author

Uno S; Katayama K; Dobashi N; Hirano A; Ogihara A; Yamazaki H; Usui N;

Kobayashi T; Inoue K; Kuraishi Y

Address

Department of Hematology/Oncology, Jikei University Hospital.

Source

Rinsho Ketsueki, 40(5):414-9 1999 May

Abstract

A 44-year-old, previously healthy man with a diagnosis of non-Hodgkin's

lymphoma (NHL, diffuse large B-cell type,

stage IIA) was treated with combination chemotherapy including vincristine

(VCR). After receiving a cumulative dose of

VCR, he experienced rapid and marked weakening which progressed to

quadriplegia and bulbar palsy. Prior to this

therapy, the patient had no neurological problems, and his siblings were

asymptomatic. Physical examination identified

pes cavus (hollow foot), and electrodiagnostic studies showed markedly

slower nerve conduction velocity of myelinated

fibers, with abundant " onion bulb " formations. Chromosomal analysis

detected 17p11.2-12 duplication, thus yielding a

diagnosis of Charcot-Marie-Tooth (CMT) 1A. CMT disease is a familial

neuromuscular disorder, and the incidence is

approximately 1 in 2,500. We concluded that if CMT disease is diagnosed,

vincristine should be avoided due to the

potential severity of neurotoxicity to small doses.

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>Becky M.