Vincristine-associated Neuropathy With Antifungal Usage: A Kaiser Northern California Experience

Journal of Pediatric Hematology/oncology
Mina NikanjamEdmund V Capparelli

Abstract

The dose-limiting toxicity for vincristine is peripheral neuropathy which can be potentiated with concurrent usage of azole antifungals. The current retrospective study assessed the incidence of concurrent vincristine and azole antifungal usage to determine if it led to increased neurotoxicity for the Kaiser Northern California pediatric acute lymphoblastic leukemia (ALL) and Hodgkin lymphoma patient population. Data were obtained from the electronic medical record (2007 to 2014). In total, 130 subjects received at least one dose of vincristine for ALL or Hodgkin lymphoma (median age 9, 88% ALL, 58% male, 47% Caucasian). Thirty one percent of patients received concurrent antifungal usage (fluconazole, 78%; voriconazole, 10%; fluconazole/voriconazole, 12%); however, concurrent antifungal usage accounted for <15% of vincristine doses. Grade 2 or greater neuropathy occurred in 51% of patients; grade 3 neuropathy was present in 8% of patients. No difference in the incidence of grade 2 or greater neuropathy was observed with the concurrent use of antifungal therapy (P=0.35), sex (P=0.59), type of cancer (P=0.41), ethnicity (P=0.29), or age (P=0.39), but was higher with increasing amount of vincristine doses (P=0.004). These results ...Continue Reading

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Citations

Jun 20, 2019·Cancer Chemotherapy and Pharmacology·Marie Lindhard MadsenKaren Dybkær
May 4, 2020·The Lancet. Haematology·Ellen M Lavoie SmithUNKNOWN Toxic Neuropathy Consortium of the Peripheral Nerve Society
Mar 9, 2021·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·Yan JinShuiying Hu

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