Vincristine-induced Peripheral Neuropathy in Pediatric ALL: A Prospective EMG Study

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Arslan B., Aycan N., Yılgör A., Erseçkin A., Karaman K.

Harran Üniversitesi Tıp Fakültesi Dergisi, cilt.23, sa.2, ss.283-289, 2026 (TRDizin)

Özet

Background: The aim of this study was to evaluate the frequency, electrophysiological characteristics, and early recovery pattern of vincristine-induced peripheral neuropathy in children with acute lymphoblastic leukemia (ALL). Materials and Methods: In this prospective study, 23 children aged 6 –18 years who were treated according to the ALL-IC BFM 2009 protocol were evaluated. Standardized nerve conduction studies and electromyography were performed at the end of chemotherapy and repeated three months after treatment completion. Based on electrophysiological findings, neuropathy was categorized as sensory, motor, or mixed. Results: At the end of treatment, peripheral neuropathy was identified in 57% of the patients, most commonly as mixed-type neuropathy. Neuropathy subtype was significantly associated with the predominantly affected extremity, with motor neuropathy occurring mainly in the lower limbs (p=0.037). During followup, the prevalence of neuropathy decreased to 13%. All sensory neuropathies resolved completely, whereas persistent motor abnormalities remained in two patients. In addition, one patient developed motor neuropathy with delayed-onset. Conclusions: Vincristine-induced peripheral neuropathy (VIPN) is frequently observed in children with ALL but demonstrates marked early improvement, particularly in sensory nerve involvement. Nevertheless, a small proportion of patients may experience persistent or late-developing motor deficits. These findings suggest that serial electrophysiological assessments may provide additional information regarding the evolution and recovery of VIPN during follow-up.