Measuring vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia

Ellen M.Lavoie Smith, Lang Li, Raymond J. Hutchinson, Richard Ho, W. Bryan Burnette, Elizabeth Wells, Celia Bridges, Jamie Renbarger

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

BACKGROUND: Vincristine-induced peripheral neuropathy (VIPN) is difficult to quantify in children. OBJECTIVE: The study objective was to examine the reliability, validity, and clinical feasibility of several VIPN measures for use in children with acute lymphoblastic leukemia. INTERVENTIONS/METHODS: Children (n = 65) aged 1 to 18 years receiving vincristine at 4 academic centers participated in the study. Baseline and pre-vincristine administration 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. The TNS-PV scores (n = 806) were obtained over 15 weeks. Blood was obtained at several time points to quantify pharmacokinetic parameters. RESULTS: Cronbach's α for a reduced TNS-PV scale was .84. The 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 range = 0.46-0.52, P = .01). FACES scores correlated with the TNS-PV neuropathic pain item (r = 0.48; P = .01) and were attainable in all ages. A 2-item V-Rex score (vibration and reflex items) was the most responsive to change (effect size = 0.65, P < 0.001). The TNS-PV scores were attainable in 95% of children 6 years or older. CONCLUSIONS: 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 or older. IMPLICATIONS FOR PRACTICE: The TNS-PV may be a useful tool for assessing vincristine toxicity in children with acute lymphoblastic leukemia.

Original languageEnglish (US)
Pages (from-to)E49-E60
JournalCancer nursing
Volume36
Issue number5
DOIs
StatePublished - Sep 1 2013

Keywords

  • Children
  • Leukemia
  • Neuropathic Pain
  • Peripheral Neuropathy
  • Reliability
  • Sensitivity
  • Total Neuropathy Score
  • Validity
  • Vincristine

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

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    Smith, E. M. L., Li, L., Hutchinson, R. J., Ho, R., Burnette, W. B., Wells, E., Bridges, C., & Renbarger, J. (2013). Measuring vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia. Cancer nursing, 36(5), E49-E60. https://doi.org/10.1097/NCC.0b013e318299ad23