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[一项关于长春新碱诱发儿童周围神经病变的队列研究]

[A cohort study of vincristine-induced peripheral neuropathy in children].

作者信息

Li Chuang, Jin Jiao, Huang Jing, Yang Xiao-Yan, Li Yan, Yan Yong-Yan, Yang Can

机构信息

Department of Pediatrics, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2023 May 15;25(5):470-475. doi: 10.7499/j.issn.1008-8830.2212032.

Abstract

OBJECTIVES

To study the characteristics of vincristine-induced peripheral neuropathy (VIPN) in children with acute lymphoblastic leukemia (ALL) and the factors influencing the development of VIPN.

METHODS

The children with ALL, aged 1-18 years, who were treated with CCCG-ALL2015 or CCCG-ALL2020 regimen in the Affiliated Hospital of Guizhou Medical University from January 2018 to February 2022 were enrolled as subjects. According to the influence of age on risk, the children were divided into 1-10 years group with 91 children and >10 years group with 29 children. VIPN was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (5th edition), and the incidence rate, severity, and type of VIPN were compared between different groups.

RESULTS

A total of 120 children were enrolled in this study, among whom 56 (46.7%) developed VIPN. The >10 years group had a significantly higher incidence rate of VIPN than the 1-10 years group (69% vs 40%, <0.05). Among the 56 children with VIPN, 12 (21%) had grade 3 VIPN or above, and 44 (79%) had grade 2 VIPN. There were 77 cases of autonomic nerve symptoms (59.7%), 42 cases of peripheral nerve injury (32.5%), and 10 cases of cranial nerve injury (7.8%). There were no significant differences in the severity and type of VIPN between the groups with different ages, sexes, degrees of risk, or treatment regimens (>0.05). The results of binary logistic regression analysis showed that age is the influencing factor for the occurrence of VIPN (>0.05).

CONCLUSIONS

There is a relatively high incidence rate of VIPN in children with ALL, with the highest incidence rate of autonomic nervous symptoms. The incidence of VIP in children over 10 years old is relatively high.

摘要

目的

研究急性淋巴细胞白血病(ALL)患儿长春新碱诱导的周围神经病变(VIPN)的特征及影响VIPN发生发展的因素。

方法

选取2018年1月至2022年2月在贵州医科大学附属医院接受CCCG - ALL2015或CCCG - ALL2020方案治疗的1 - 18岁ALL患儿作为研究对象。根据年龄对风险的影响,将患儿分为1 - 10岁组91例和>10岁组29例。根据美国国立癌症研究所不良事件通用术语标准(第5版)对VIPN进行分级,比较不同组间VIPN的发生率、严重程度及类型。

结果

本研究共纳入120例患儿,其中56例(46.7%)发生VIPN。>10岁组VIPN发生率显著高于1 - 10岁组(69%对40%,P<0.05)。在56例发生VIPN的患儿中,12例(21%)为3级及以上VIPN,44例(79%)为2级VIPN。自主神经症状77例(59.7%),周围神经损伤42例(32.5%),脑神经损伤10例(7.8%)。不同年龄、性别、危险度或治疗方案组间VIPN的严重程度及类型差异均无统计学意义(P>0.05)。二元logistic回归分析结果显示,年龄是VIPN发生的影响因素(P>0.05)。

结论

ALL患儿中VIPN发生率较高,以自主神经症状发生率最高。10岁以上儿童VIP发生率相对较高。

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