Chemotherapeutic drugs are the most common toxic agents for peripheral nerves. Vincristine is a vinca alkaloid drug that is used for the treatment of several malignancies in combination with other chemotherapeutic agents. Treatment with intravenous (IV) vincristine at doses above 5 mg leads to a dose-dependent neuropathy with sensory symptoms but higher cumulative doses at around 30 to 50 mg are needed for the development of motor symptoms. The standard maximum adult IV vincristine dose is 2 mg IV per dose given at weekly intervals. However, administration of a single 2-mg dose IV vincristine may rarely result in the development of peripheral neuropathy. Few case reports have been presented on vincristine-associated severe paralysis in patients with preexisting hereditary neuropathy like Charcot-Marie Tooth (CMT) disease, who received doses even lower than 2 mg. Herein, we reported a Hodgkin lymphoma patient who developed severe polyneuropathy after receiving 2 mg vincristine treatment and was subsequently found to carry the CMT1A duplication responsible for CMT disease.
*Departments of *Medical Oncology
†Hematology, Internal Medicine
‡Neurology, Dicle University, Diyarbakir
§Department of Molecular Biology and Genetics, Bogazici University, Istanbul, Turkey
This work is partially supported by a grand from Bogazici University Research Fund (96B0154).
Reprints: Timucin Cil, MD, Department of Medical Oncology, Internal Medicine, Dicle University, 21280 Diyarbakir, Turkey (e-mail: email@example.com).
Received for publication December 14, 2008
accepted June 2, 2009