Persistence of Chemotherapy-Induced Peripheral Neuropathy Despite Vincristine Reduction in Childhood B-Acute Lymphoblastic Leukemia
Abstract Background Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children’s Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subse...
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| Veröffentlicht in: | JNCI : Journal of the National Cancer Institute 2022-08, Vol.114 (8), p.1167-1175 |
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| creator | Rodwin, Rozalyn L Kairalla, John A Hibbitts, Emily Devidas, Meenakshi Whitley, Moira K Mohrmann, Caroline E Schore, Reuven J Raetz, Elizabeth Winick, Naomi J Hunger, Stephen P Loh, Mignon L Hockenberry, Marilyn J Angiolillo, Anne L Ness, Kirsten K Kadan-Lottick, Nina S |
| description | Abstract
Background
Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children’s Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group.
Methods
AALL0932 standard-B-ALL patients aged 3 years and older were evaluated at T1-T4 (end consolidation, maintenance month 1, maintenance month 18, 12 months posttherapy). Physical and occupational therapists (PT/OT) measured motor CIPN (hand and ankle strength, dorsiflexion and plantarflexion range of motion), sensory CIPN (finger and toe vibration and touch), function (dexterity [Purdue Pegboard], and walking efficiency [Six-Minute Walk]). Proxy-reported function (Pediatric Outcome Data Collection Instrument) and quality of life (Pediatric Quality of Life Inventory) were assessed. Age- and sex-matched z scores and proportion impaired were measured longitudinally and compared between groups.
Results
Consent and data were obtained from 150 participants (mean age = 5.1 years [SD = 1.7], 48.7% female). Among participants with completed evaluations, 81.8% had CIPN at T1 (74.5% motor, 34.1% sensory). When examining severity of PT/OT outcomes, only handgrip strength (P |
| doi_str_mv | 10.1093/jnci/djac095 |
| format | Article |
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Background
Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children’s Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group.
Methods
AALL0932 standard-B-ALL patients aged 3 years and older were evaluated at T1-T4 (end consolidation, maintenance month 1, maintenance month 18, 12 months posttherapy). Physical and occupational therapists (PT/OT) measured motor CIPN (hand and ankle strength, dorsiflexion and plantarflexion range of motion), sensory CIPN (finger and toe vibration and touch), function (dexterity [Purdue Pegboard], and walking efficiency [Six-Minute Walk]). Proxy-reported function (Pediatric Outcome Data Collection Instrument) and quality of life (Pediatric Quality of Life Inventory) were assessed. Age- and sex-matched z scores and proportion impaired were measured longitudinally and compared between groups.
Results
Consent and data were obtained from 150 participants (mean age = 5.1 years [SD = 1.7], 48.7% female). Among participants with completed evaluations, 81.8% had CIPN at T1 (74.5% motor, 34.1% sensory). When examining severity of PT/OT outcomes, only handgrip strength (P < .001) and walking efficiency (P = .02) improved from T1-T4, and only dorsiflexion range of motion (46.7% vs 14.7%; P = .008) and handgrip strength (22.2% vs 37.1%; P = .03) differed in vincristine and dexamethasone every 4 weeks vs vincristine and dexamethasone 12 weeks at T4. Proxy-reported outcomes improved from T1 to T4 (P < .001), and most did not differ between groups.
Conclusions
CIPN is prevalent early in B-ALL therapy and persists at least 12 months posttherapy. Most outcomes did not differ between treatment groups despite reduction in vincristine frequency. Children with B-ALL should be monitored for CIPN, even with reduced vincristine frequency.</description><identifier>ISSN: 0027-8874</identifier><identifier>EISSN: 1460-2105</identifier><identifier>DOI: 10.1093/jnci/djac095</identifier><identifier>PMID: 35552709</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Acute lymphoblastic leukemia ; Ankle ; Antineoplastic Agents - therapeutic use ; Chemotherapy ; Child ; Child, Preschool ; Children ; Data collection ; Dexamethasone ; Dexamethasone - therapeutic use ; Evaluation ; Female ; Hand Strength ; Humans ; Leukemia ; Longitudinal Studies ; Maintenance ; Male ; Pediatrics ; Peripheral Nervous System Diseases - chemically induced ; Peripheral neuropathy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy ; Quality of Life ; Range of motion ; Reduction ; Vibration ; Vincristine ; Vincristine - adverse effects ; Walking</subject><ispartof>JNCI : Journal of the National Cancer Institute, 2022-08, Vol.114 (8), p.1167-1175</ispartof><rights>The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-a6d90717d4a725c45b477e69306f2f39908de4b242eacf1d20059b0b674336103</citedby><cites>FETCH-LOGICAL-c444t-a6d90717d4a725c45b477e69306f2f39908de4b242eacf1d20059b0b674336103</cites><orcidid>0000-0002-6857-396X ; 0000-0002-5492-3957 ; 0000-0002-5243-3284 ; 0000-0002-6636-3870</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35552709$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodwin, Rozalyn L</creatorcontrib><creatorcontrib>Kairalla, John A</creatorcontrib><creatorcontrib>Hibbitts, Emily</creatorcontrib><creatorcontrib>Devidas, Meenakshi</creatorcontrib><creatorcontrib>Whitley, Moira K</creatorcontrib><creatorcontrib>Mohrmann, Caroline E</creatorcontrib><creatorcontrib>Schore, Reuven J</creatorcontrib><creatorcontrib>Raetz, Elizabeth</creatorcontrib><creatorcontrib>Winick, Naomi J</creatorcontrib><creatorcontrib>Hunger, Stephen P</creatorcontrib><creatorcontrib>Loh, Mignon L</creatorcontrib><creatorcontrib>Hockenberry, Marilyn J</creatorcontrib><creatorcontrib>Angiolillo, Anne L</creatorcontrib><creatorcontrib>Ness, Kirsten K</creatorcontrib><creatorcontrib>Kadan-Lottick, Nina S</creatorcontrib><title>Persistence of Chemotherapy-Induced Peripheral Neuropathy Despite Vincristine Reduction in Childhood B-Acute Lymphoblastic Leukemia</title><title>JNCI : Journal of the National Cancer Institute</title><addtitle>J Natl Cancer Inst</addtitle><description>Abstract
Background
Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children’s Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group.
Methods
AALL0932 standard-B-ALL patients aged 3 years and older were evaluated at T1-T4 (end consolidation, maintenance month 1, maintenance month 18, 12 months posttherapy). Physical and occupational therapists (PT/OT) measured motor CIPN (hand and ankle strength, dorsiflexion and plantarflexion range of motion), sensory CIPN (finger and toe vibration and touch), function (dexterity [Purdue Pegboard], and walking efficiency [Six-Minute Walk]). Proxy-reported function (Pediatric Outcome Data Collection Instrument) and quality of life (Pediatric Quality of Life Inventory) were assessed. Age- and sex-matched z scores and proportion impaired were measured longitudinally and compared between groups.
Results
Consent and data were obtained from 150 participants (mean age = 5.1 years [SD = 1.7], 48.7% female). Among participants with completed evaluations, 81.8% had CIPN at T1 (74.5% motor, 34.1% sensory). When examining severity of PT/OT outcomes, only handgrip strength (P < .001) and walking efficiency (P = .02) improved from T1-T4, and only dorsiflexion range of motion (46.7% vs 14.7%; P = .008) and handgrip strength (22.2% vs 37.1%; P = .03) differed in vincristine and dexamethasone every 4 weeks vs vincristine and dexamethasone 12 weeks at T4. Proxy-reported outcomes improved from T1 to T4 (P < .001), and most did not differ between groups.
Conclusions
CIPN is prevalent early in B-ALL therapy and persists at least 12 months posttherapy. Most outcomes did not differ between treatment groups despite reduction in vincristine frequency. Children with B-ALL should be monitored for CIPN, even with reduced vincristine frequency.</description><subject>Acute lymphoblastic leukemia</subject><subject>Ankle</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Data collection</subject><subject>Dexamethasone</subject><subject>Dexamethasone - therapeutic use</subject><subject>Evaluation</subject><subject>Female</subject><subject>Hand Strength</subject><subject>Humans</subject><subject>Leukemia</subject><subject>Longitudinal Studies</subject><subject>Maintenance</subject><subject>Male</subject><subject>Pediatrics</subject><subject>Peripheral Nervous System Diseases - chemically induced</subject><subject>Peripheral neuropathy</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy</subject><subject>Quality of Life</subject><subject>Range of motion</subject><subject>Reduction</subject><subject>Vibration</subject><subject>Vincristine</subject><subject>Vincristine - adverse effects</subject><subject>Walking</subject><issn>0027-8874</issn><issn>1460-2105</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGP1CAUh4nRuLOrN8-GxIMX675SWsrFZB1X3WSixqhXQuHVMk6hC63JnP3HZTLjRi9yIYGPj_fej5AnJbwsQVaXW2_cpd1qA7K-R1Ylb6BgJdT3yQqAiaJtBT8j5yltIS_J-ENyVtV1zQTIFfn1CWNyaUZvkIaergccwzxg1NO-uPF2MWhpZtx0ONvRD7jEMOl52NM3mCY3I_3mvIlZ4TzSz5hfzC546nx2uZ0dQrD0dXFlloxu9uM0hG6nM23oBpcfODr9iDzo9S7h49N-Qb6-vf6yfl9sPr67WV9tCsM5nwvdWAmiFJZrwWrD644LgY2soOlZX0kJrUXeMc5Qm760DKCWHXSN4FXVlFBdkFdH77R0I1qDfs4tqSm6Uce9Ctqpf2-8G9T38FPJqgFet1nw7CSI4XbBNKttWKLPNas8zbKpWsmaTL04UiaGlCL2dz-UoA6RqUNk6hRZxp_-XdUd_CejDDw_AmGZ_q_6DSfbo5s</recordid><startdate>20220808</startdate><enddate>20220808</enddate><creator>Rodwin, Rozalyn L</creator><creator>Kairalla, John A</creator><creator>Hibbitts, Emily</creator><creator>Devidas, Meenakshi</creator><creator>Whitley, Moira K</creator><creator>Mohrmann, Caroline E</creator><creator>Schore, Reuven J</creator><creator>Raetz, Elizabeth</creator><creator>Winick, Naomi J</creator><creator>Hunger, Stephen P</creator><creator>Loh, Mignon L</creator><creator>Hockenberry, Marilyn J</creator><creator>Angiolillo, Anne L</creator><creator>Ness, Kirsten K</creator><creator>Kadan-Lottick, Nina S</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6857-396X</orcidid><orcidid>https://orcid.org/0000-0002-5492-3957</orcidid><orcidid>https://orcid.org/0000-0002-5243-3284</orcidid><orcidid>https://orcid.org/0000-0002-6636-3870</orcidid></search><sort><creationdate>20220808</creationdate><title>Persistence of Chemotherapy-Induced Peripheral Neuropathy Despite Vincristine Reduction in Childhood B-Acute Lymphoblastic Leukemia</title><author>Rodwin, Rozalyn L ; Kairalla, John A ; Hibbitts, Emily ; Devidas, Meenakshi ; Whitley, Moira K ; Mohrmann, Caroline E ; Schore, Reuven J ; Raetz, Elizabeth ; Winick, Naomi J ; Hunger, Stephen P ; Loh, Mignon L ; Hockenberry, Marilyn J ; Angiolillo, Anne L ; Ness, Kirsten K ; Kadan-Lottick, Nina S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-a6d90717d4a725c45b477e69306f2f39908de4b242eacf1d20059b0b674336103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acute lymphoblastic leukemia</topic><topic>Ankle</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Data collection</topic><topic>Dexamethasone</topic><topic>Dexamethasone - therapeutic use</topic><topic>Evaluation</topic><topic>Female</topic><topic>Hand Strength</topic><topic>Humans</topic><topic>Leukemia</topic><topic>Longitudinal Studies</topic><topic>Maintenance</topic><topic>Male</topic><topic>Pediatrics</topic><topic>Peripheral Nervous System Diseases - chemically induced</topic><topic>Peripheral neuropathy</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy</topic><topic>Quality of Life</topic><topic>Range of motion</topic><topic>Reduction</topic><topic>Vibration</topic><topic>Vincristine</topic><topic>Vincristine - adverse effects</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodwin, Rozalyn L</creatorcontrib><creatorcontrib>Kairalla, John A</creatorcontrib><creatorcontrib>Hibbitts, Emily</creatorcontrib><creatorcontrib>Devidas, Meenakshi</creatorcontrib><creatorcontrib>Whitley, Moira K</creatorcontrib><creatorcontrib>Mohrmann, Caroline E</creatorcontrib><creatorcontrib>Schore, Reuven J</creatorcontrib><creatorcontrib>Raetz, Elizabeth</creatorcontrib><creatorcontrib>Winick, Naomi J</creatorcontrib><creatorcontrib>Hunger, Stephen P</creatorcontrib><creatorcontrib>Loh, Mignon L</creatorcontrib><creatorcontrib>Hockenberry, Marilyn J</creatorcontrib><creatorcontrib>Angiolillo, Anne L</creatorcontrib><creatorcontrib>Ness, Kirsten K</creatorcontrib><creatorcontrib>Kadan-Lottick, Nina S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JNCI : Journal of the National Cancer Institute</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodwin, Rozalyn L</au><au>Kairalla, John A</au><au>Hibbitts, Emily</au><au>Devidas, Meenakshi</au><au>Whitley, Moira K</au><au>Mohrmann, Caroline E</au><au>Schore, Reuven J</au><au>Raetz, Elizabeth</au><au>Winick, Naomi J</au><au>Hunger, Stephen P</au><au>Loh, Mignon L</au><au>Hockenberry, Marilyn J</au><au>Angiolillo, Anne L</au><au>Ness, Kirsten K</au><au>Kadan-Lottick, Nina S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Persistence of Chemotherapy-Induced Peripheral Neuropathy Despite Vincristine Reduction in Childhood B-Acute Lymphoblastic Leukemia</atitle><jtitle>JNCI : Journal of the National Cancer Institute</jtitle><addtitle>J Natl Cancer Inst</addtitle><date>2022-08-08</date><risdate>2022</risdate><volume>114</volume><issue>8</issue><spage>1167</spage><epage>1175</epage><pages>1167-1175</pages><issn>0027-8874</issn><eissn>1460-2105</eissn><abstract>Abstract
Background
Children with B-acute lymphoblastic leukemia (B-ALL) are at risk for chemotherapy-induced peripheral neuropathy (CIPN). Children’s Oncology Group AALL0932 randomized reduction in vincristine and dexamethasone (every 4 weeks vs 12 weeks during maintenance in the average-risk subset of National Cancer Institute standard-B-ALL (SR AR B-ALL). We longitudinally measured CIPN, overall and by treatment group.
Methods
AALL0932 standard-B-ALL patients aged 3 years and older were evaluated at T1-T4 (end consolidation, maintenance month 1, maintenance month 18, 12 months posttherapy). Physical and occupational therapists (PT/OT) measured motor CIPN (hand and ankle strength, dorsiflexion and plantarflexion range of motion), sensory CIPN (finger and toe vibration and touch), function (dexterity [Purdue Pegboard], and walking efficiency [Six-Minute Walk]). Proxy-reported function (Pediatric Outcome Data Collection Instrument) and quality of life (Pediatric Quality of Life Inventory) were assessed. Age- and sex-matched z scores and proportion impaired were measured longitudinally and compared between groups.
Results
Consent and data were obtained from 150 participants (mean age = 5.1 years [SD = 1.7], 48.7% female). Among participants with completed evaluations, 81.8% had CIPN at T1 (74.5% motor, 34.1% sensory). When examining severity of PT/OT outcomes, only handgrip strength (P < .001) and walking efficiency (P = .02) improved from T1-T4, and only dorsiflexion range of motion (46.7% vs 14.7%; P = .008) and handgrip strength (22.2% vs 37.1%; P = .03) differed in vincristine and dexamethasone every 4 weeks vs vincristine and dexamethasone 12 weeks at T4. Proxy-reported outcomes improved from T1 to T4 (P < .001), and most did not differ between groups.
Conclusions
CIPN is prevalent early in B-ALL therapy and persists at least 12 months posttherapy. Most outcomes did not differ between treatment groups despite reduction in vincristine frequency. Children with B-ALL should be monitored for CIPN, even with reduced vincristine frequency.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>35552709</pmid><doi>10.1093/jnci/djac095</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6857-396X</orcidid><orcidid>https://orcid.org/0000-0002-5492-3957</orcidid><orcidid>https://orcid.org/0000-0002-5243-3284</orcidid><orcidid>https://orcid.org/0000-0002-6636-3870</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford Academic Journals (OUP); Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Acute lymphoblastic leukemia Ankle Antineoplastic Agents - therapeutic use Chemotherapy Child Child, Preschool Children Data collection Dexamethasone Dexamethasone - therapeutic use Evaluation Female Hand Strength Humans Leukemia Longitudinal Studies Maintenance Male Pediatrics Peripheral Nervous System Diseases - chemically induced Peripheral neuropathy Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy Quality of Life Range of motion Reduction Vibration Vincristine Vincristine - adverse effects Walking |
| title | Persistence of Chemotherapy-Induced Peripheral Neuropathy Despite Vincristine Reduction in Childhood B-Acute Lymphoblastic Leukemia |
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