neuropathy & vincristine

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Evaluation of vincristine-induced neuropathy in
children with ALL and NHL in the Al-Bairouni
University Hospital in Damascus

• Dr.Mohammad Dorchin
• Oncology Department,Dezfol University of Medical
  Sciences ,Dezfol, Iran
• Dr.Seham Soleiman, Dr.Moha Manashi
• Oncology department, AlBairouni University
  Hospital, Medical faculty,
• Damascus University 

25th International Congress of Pediatrics Tehran
- Iran
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Introduction

• Vincristine, a chemotherapy drug useful in the
  treatment of leukemias, lymphomas and solid
  tumors is vast potential is a potent neurotoxin
  and sensory neuropathy - a common behavioral
  toxicity of this drug.

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Methods

• The study was retrospective and descriptive study
  of vincristine neuropathy in 152 patients with
  ALL and NHL from 2007/6/1Until 2009/6/30 that
  referred to our hospital in Damascus, Syria
  (inpatient and outpatient) are discussed.

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Al-Bairouni University Hospital
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Dr.Seham SoleimanHemato oncologist

• Dr.Moha Manachi
• Oncologist

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Statistical Analyses

• Table 1 shows total new cancer cases referred to
  the Al-bairouni hospital from 2007-2009

Year New cases NHL ALL Pt,s in my study Pt,s in my study Percentage
Year New cases NHL ALL NHL ALL Percentage
2007 8943 86 34 23 12 0.31
2008 9058 101 68 31 15 0.51
2009 9774 97 55 43 28 0.7
Total 27775 284 157 97 55 0.5
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Treatment Dose of Vincristine

• ALL
• Vincristine
• 1.5 mg/m2 IV (max dose 2mg)

• NHL
• Vincristine
• 1.4mg/m2 IV (max dose 2mg)

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Results

• A Geographic Distribution
• B. Incidence according to the Age group
• C. Incidence according Sex
• D. Incidence according to the diseases
• E. Results of sensory peripheral neuropathy
  assessments using Vincristine

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A Geographic Distribution
Cities Damascus Aleppo Countryside of Damascus Homs Dar,a Lattaquieh Hom,a Tartoos Al-Reke Al-Sowida
Patients 62 19 20 14 10 9 5 5 4 4
Percentage 41 13 13 9 6 6 3 3 3 3
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The most patients were from Damascus and Aleppo
provinces, and seaboard patients were the less
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B. Incidence according to the Age group
  cases Percentage
Less than 5 12 7
6-10 39 26
11-15 54 35
16 - 20 45 30
More than 20 2 2

• average age of 12.3 years

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C. Incidence according Sex
  Male Female Total
Case 93 59 152
Percentage 61 39 100
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D. Incidence according to the diseases
Diseases NHL ALL Total
Cases 91 51 152
Percentage 59.8 40.2 100
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Side Effects in my patients that used Vincristine

• Vincristine neuropathy
• 1- Sensory neuropathy, mostly Hyperesthesia
  contralateral hand or foot or both in 23
  cases(15.1)
• 2 - Visceral neuropathy, ( ileus, constipation,
  diarrhea)
• In 11 cases (7/12)
• 3 - Motor neuropathy
• (Bell, s palsy , Hoarseness, jaw pain
• Facial palsy) in 15 patients (9/5),

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• The mean age of patients with neuropathy, 12.3 Y
  and the mean age of patients without this
  complication,9 Y, respectively.

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• The mean age of patients with
• motor neuropathy, 14.5 Y
• The average age of patients with
• visceral neuropathy, 16 Y , respectively

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Conclusion

• Vincristine neuropathy is a common complication,
  its incidence increases with age.
• Visceral neuropathy, motor neuropathy mainly in
  people over 50 years and is seen mainly in people
  less than 20 years of age.

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Conclusion

• The incidence of visceral or motor neuropathy,
  amputation is necessary, but in some cases drugs
  sensory neuropathy can be tolerated in patients
  with mild or the dose reduced by half,.

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The Best Physician Is GOD
The Best Physician Is GOD
Thanks For Your Kindly Attention