Severe Neurotoxicities in a Case of Charcot-Marie-Tooth Disease Type 2 Caused by Vincristine for Acute Lymphoblastic Leukemia
Severe Neurotoxicities in a Case of Charcot-Marie-Tooth Disease Type 2 Caused by Vincristine for Acute Lymphoblastic Leukemia
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DOI：
10.1097/mph.0b013e31816624a4
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发表时间：
2008-07
期刊：
影响因子：
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通讯作者：
T. Nishikawa;K. Kawakami;T. Kumamoto;Shiro Tonooka;A. Abe;K. Hayasaka;Y. Okamoto;Y. Kawano
中科院分区：
文献类型：
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作者：
T. Nishikawa;K. Kawakami;T. Kumamoto;Shiro Tonooka;A. Abe;K. Hayasaka;Y. Okamoto;Y. Kawano
我们报告一位13岁男性患者，患有腓骨肌萎缩症（CMT）2型，因急性淋巴细胞白血病使用长春新碱（VCR）而发生严重神经病变。在急性淋巴细胞白血病缓解诱导治疗（包括总剂量为8 mg/m2的VCR）后，观察到步态笨拙、手指肌无力和下肢倒置香槟酒瓶状肌肉。电生理研究显示正中运动神经传导速度几乎正常（约50 m/s），M波振幅明显降低，感觉障碍。根据他的症状和电生理检查结果，他被诊断为CMT 2型。他的症状逐渐恶化，甚至在VCR停用后，他仍无法独自行走7个月。之前认为VCR在2型CMT中相对安全，但是，一些2型CMT患者可能显示重度神经系统毒性，如1型CMT患者中所见。
We report a 13-year-old male patient with Charcot-Marie-Tooth disease (CMT) type 2 who developed severe neuropathy because of vincristine (VCR) for his acute lymphoblastic leukemia. A clumsy gait, muscle weakness in his fingers, and inverted champagne bottlelike muscle in the lower limbs were noticed after remission induction treatment for acute lymphoblastic leukemia, which included VCR at a total dose of 8 mg/m2. An electrophysiologic study showed an almost normal median motor nerve conduction velocity (approximately 50 m/s), markedly reduced M-wave amplitude and sensory disturbance. He was diagnosed as CMT type 2 based on his symptoms and electrophysiologic findings. His symptoms gradually worsened, and even after VCR was discontinued, he could not walk alone for 7 months. VCR has previously been considered to be relatively safe in CMT type 2, however, some patients with CMT type 2 might show severe neurologic toxicities, as seen in patients with CMT type 1.