Department of Pediatrics, Faculty of Medicine Universitas Airlangga / Dr Soetomo General Academic Hospital, Surabaya - Indonesia.
J Med Invest. 2021;68(3.4):232-237. doi: 10.2152/jmi.68.232.
Objective : This study analysed Vincristine-induced peripheral neuropathy (VIPN) risk factors in Acute Lymphoblastic Leukaemia (ALL) children. Method : This cross-sectional study design was performed at Dr. Soetomo Hospital, Surabaya, Indonesia, from August to October 2019. It included ALL children, aged 4-18 years, undergoing the 2013 or 2018 ALL Indonesian Protocol of Chemotherapy, with a cumulative vincristine dose ≥ 12 mg / m2. VIPN diagnosis is based on complaints, the Total Neuropathy Score Pediatric Vincristine (TNS-PV), and nerve conduction studies (NCS). The examined risk factors were sex, age, ALL classification, nutritional status, impaired liver function, and cumulative vincristine dose. Results : There were 52 ALL children : median age 7 years, 59.6% boys, 59.6% ALL standard risk, 44.2% experienced impaired liver function at initial ALL diagnosis. Based on a single parameter for diagnosis, 26.9% had VIPN based on complaints, 76.9% had it based on the TNS-PV, and 100% had it based on NCS. VIPN was diagnosed in 25% of children, with predominantly motor impairment and located in lower extremities. Impaired liver function is a risk factor for VIPN in ALL children (p = 0.046, prevalence ratio (PR) 2.84). Conclusion : Impaired liver function is a significant risk factor for VIPN in ALL children. J. Med. Invest. 68 : 232-237, August, 2021.
本研究分析了长春新碱诱导的周围神经病变(VIPN)在急性淋巴细胞白血病(ALL)儿童中的危险因素。方法:本横断面研究于 2019 年 8 月至 10 月在印度尼西亚泗水苏托莫医院进行,纳入接受 2013 年或 2018 年印度尼西亚 ALL 化疗方案、累积长春新碱剂量≥12mg/m2的 4-18 岁 ALL 儿童。VIPN 诊断基于主诉、儿童长春新碱总神经病变评分(TNS-PV)和神经传导研究(NCS)。检查的危险因素包括性别、年龄、ALL 分类、营养状况、肝功能受损和累积长春新碱剂量。结果:共纳入 52 例 ALL 儿童:中位年龄 7 岁,59.6%为男性,59.6%为 ALL 标准风险,44.2%在 ALL 初诊时肝功能受损。基于单一参数诊断,26.9%基于主诉、76.9%基于 TNS-PV、100%基于 NCS 诊断为 VIPN。25%的儿童诊断为 VIPN,主要表现为运动功能障碍,位于下肢。肝功能受损是 ALL 儿童 VIPN 的危险因素(p=0.046,患病率比(PR)2.84)。结论:肝功能受损是 ALL 儿童 VIPN 的重要危险因素。医学研究杂志 68:232-237,2021 年 8 月。