Measuring vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia.
Measuring vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia.
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DOI：
10.1097/ncc.0b013e318299ad23
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发表时间：
2013-09
期刊：
影响因子：
2.6
通讯作者：
Renbarger J
中科院分区：
文献类型：
--
作者：
Lavoie Smith EM;Li L;Hutchinson RJ;Ho R;Burnette WB;Wells E;Bridges C;Renbarger J
长春新碱引起的儿童周围神经病变（VIPN）很难量化。该研究的目的是检验几种用于治疗急性淋巴细胞白血病儿童的 VIPN 措施的可靠性、有效性和临床可行性。在四个学术中心接受长春新碱治疗的 1-18 岁儿童（N = 65）参与了这项研究。使用儿童长春新碱总神经病变评分 (TNS-PV)、美国国家癌症研究所不良事件通用术语标准、Balis 分级量表和 FACES 疼痛量表获得基线和长春新碱治疗前 VIPN 评估。 TNS-PV 评分 (n = 806) 是在 15 周内获得的。在几个时间点采集血液以量化药代动力学参数。减少的 TNS-PV 量表的 Cronbach α 值为 0.84。 TNS-PV 评分与累积长春新碱剂量（r = 0.53，p = 0.01）、药代动力学参数（r = 0.41，p = 0.05）和分级量表评分（r = 0.46 – 0.52；p = 0.01）相关。 FACES 评分与 TNS-PV 神经性疼痛项目相关（r = 0.48；p = 0.01），并且在所有年龄段均可达到。 2 项 V-Rex 评分（振动和反射项）对变化反应最灵敏（es 0.65，p < 0.001）。 95% ≥ 6 岁的儿童可获得 TNS-PV 评分。 TNS-PV 对于测量 VIPN 来说是可靠且有效的。它对随时间（15 周）的变化很敏感，适合 6 岁以上的儿童使用。 TNS-PV 可能是评估长春新碱对急性淋巴细胞白血病儿童的毒性的有用工具。
Vincristine-induced peripheral neuropathy (VIPN) is difficult to quantify in children. The study objective was to examine the reliability, validity, and clinical feasibility of several VIPN measures for use in children with acute lymphoblastic leukemia. Children (N = 65) aged 1–18 years receiving vincristine at four academic centers participated in the study. Baseline and pre-vincristine VIPN assessments were obtained using the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), the National Cancer Institute Common Terminology Criteria for Adverse Events, the Balis grading scale, and the FACES pain scale. TNS-PV scores (n = 806) were obtained over 15 weeks. Blood was obtained at several time-points to quantify pharmacokinetic parameters. Cronbach’s alpha for a reduced TNS-PV scale was 0.84. TNS-PV scores correlated with cumulative vincristine dosage (r = 0.53, p = 0.01), pharmacokinetic parameters (r = 0.41, p = 0.05), and grading scale scores (r = 0.46 – 0.52; p = 0.01). FACES scores correlated with the TNS-PV neuropathic pain item (r = 0.48; p = 0.01), and were attainable in all ages. A 2-item V-Rex score (vibration and reflex items) was the most responsive to change (es 0.65, p < 0.001). TNS-PV scores were attainable in 95% of children ≥ 6 years. The TNS-PV is reliable and valid for measuring VIPN. It is sensitive to change over time (15 weeks) and feasible for use in children ≥ 6 years of age. The TNS-PV may be a useful tool for assessing vincristine toxicity in children with acute lymphoblastic leukemia.