Experience with vincristine--associated neurotoxicity.

OBJECTIVES To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity. DESIGN A retrospective case series study. SETTING Hurlingham Oncology Clinic, Nairobi. SUBJECTS Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens. MAIN OUTCOME MEASURES The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2. RESULTS Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV-positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine. CONCLUSION Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.