Cil Timucin, Altintas Abdullah, Tamam Yusuf, Battaloğlu Esra, Isikdogan Abdurrahman
Department of Medical Oncology, Internal Medicine, Dicle University, Diyarbakir, Turkey.
J Pediatr Hematol Oncol. 2009 Oct;31(10):787-9. doi: 10.1097/MPH.0b013e3181b530ad.
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.
化疗药物是导致周围神经毒性的最常见药物。长春新碱是一种长春花生物碱类药物，与其他化疗药物联合用于治疗多种恶性肿瘤。静脉注射长春新碱剂量超过5毫克时会导致剂量依赖性神经病变，出现感觉症状，但出现运动症状则需要累积剂量达到约30至50毫克。成人静脉注射长春新碱的标准最大剂量为每次2毫克，每周给药一次。然而，单次静脉注射2毫克长春新碱很少会导致周围神经病变。很少有病例报告显示，患有遗传性神经病如夏科-马里-图斯（CMT）病的患者，接受的剂量甚至低于2毫克，却出现了长春新碱相关的严重麻痹。在此，我们报告了一名霍奇金淋巴瘤患者，在接受2毫克长春新碱治疗后出现严重多发性神经病变，随后被发现携带导致CMT病的CMT1A重复突变。
