EXPERIENCE WITH VINCRISTINE - ASSOCIATEC NEUROTOXICITY

Abstract

Objectives: To evaluate the frequency and severity of occurrence of vincristine-associated
neurotoxicity .
Design: A retrospective case series study
Setting: Hurlingham Oncology Clinic, Nairobi.
Subjects: Thirty-eight patients treated for various neoplasms with vincristine containing
chemotherapeutic regimens.
Main outcome measures: The frequency and degree of neuroto:;icity when vincristine was
given at the standard dose of 1.4 mg/mZ.
Results: Five patients (13.2%) developed peripheral neuropatl~y, one having had it even
before vincristine was started. Therefore only four (10.5 %'1 had it attributed to vincristine.
Four of the patients who developed neuropathy (80%) were HIV-I ~ositive. Neuropathy grade
2 (severe) occurred in only two patients leading to discontinuation of the drug. All the
neurotoxicity resolved after discontinuation of vincristint
Conclusion: Vincristine induced neuropathy occurred but was ri~rely severe at a dose of 1.4
mg/m2. It appeared to be more frequent in HIV infected individi als, but controlled studies
with bigger sample sizes are required to determine whether I his may warrant routine
capping of the dose at a maximum of 2 mg.