Neuropathy in Lymphoblastic Leukemia Treated With Vincristine

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Abstract
Vincristine INCRISTINE sulfate (Oncovin), an alkaloid isolated from Vinca rosea, has proven oncolytic activity in experimental and human neoplasms. Its main drawback in the treatment of human beings has been the severe neurotoxicity which produces numbness and anesthesia in the fingers and toes; paresthesias, and slapping gait1; absent reflexes in the lower extremities, abducens palsy, visual disturbances, extensor weakness of the hands and feet2; persistent paresis3; bilateral foot drop and ataxia.4 The degree of neuromuscular intoxication and apparent reversibility vary. In one report symptoms continued as long as treatment was maintained but eventually disappeared six weeks after treatment was stopped.1 In another study 14 of 16 patients who had received vincristine for more than two months lost the deep tendon reflexes of the lower extremities, but the period of observation was too short for comment on reversibility. In the same report muscle weakness was