van de Velde Mirjam E, Kaspers Gertjan L, Abbink Floor C H, Wilhelm Abraham J, Ket Johannes C F, van den Berg Marleen H
Department of Pediatric Hematology/Oncology, VU University Medical Center Amsterdam, Postbus 7057, 1007, MB, Amsterdam, The Netherlands.
Department of Pediatric Hematology/Oncology, VU University Medical Center Amsterdam, Postbus 7057, 1007, MB, Amsterdam, The Netherlands; Academy, Princess Máxima Center for Pediatric Oncology Utrecht, Lundlaan 6, Utrecht, The Netherlands.
Crit Rev Oncol Hematol. 2017 Jun;114:114-130. doi: 10.1016/j.critrevonc.2017.04.004. Epub 2017 Apr 6.
Vincristine-induced peripheral neuropathy (VIPN) is a dose-limiting side effect of vincristine (VCR) treatment in children, leading to diminished quality of life. Much remains unknown about the underlying mechanisms of VIPN. This review systematically summarizes the available literature concerning contributing factors of VIPN development in children. Studied factors include patient characteristics, VCR dose, administration method, pharmacokinetics, and genetic factors. Furthermore, this review reports on currently available tools to assess VIPN in children. In total, twenty-eight publications were included. Results indicate that Caucasian race, higher VCR dose, older age and low clearance negatively influence VIPN, although results regarding the latter two factors were rather conflicting. Moreover, genetic pathways influencing VIPN were identified. Furthermore, the studied tools to assess VIPN seriously impairs comparability across study results. Studying the factors and their interactions that seem to influence VIPN in children, should aid in personalized VCR treatment, thereby increasing VCR effectiveness while minimizing toxicity.
长春新碱诱导的周围神经病变(VIPN)是儿童长春新碱(VCR)治疗的剂量限制性副作用,会导致生活质量下降。关于VIPN的潜在机制仍有许多未知之处。本综述系统总结了有关儿童VIPN发生的相关因素的现有文献。研究的因素包括患者特征、VCR剂量、给药方法、药代动力学和遗传因素。此外,本综述报告了目前可用于评估儿童VIPN的工具。总共纳入了28篇出版物。结果表明,白种人、较高的VCR剂量、年龄较大和清除率较低对VIPN有负面影响,尽管关于后两个因素的结果相当矛盾。此外,还确定了影响VIPN的遗传途径。此外,所研究的评估VIPN的工具严重损害了研究结果之间的可比性。研究似乎影响儿童VIPN的因素及其相互作用,应有助于VCR的个性化治疗,从而提高VCR的有效性,同时将毒性降至最低。