I have treated two adults with lymphoma who were treated with pediatric
protocols including Vincristine and they both developed significant distal LE
weakness with foot drop. Not, however with such sudden onset. I know it’s a
known neurotoxicity agent.
I wish this young man luck.
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________________________________
From: aptaoncology-bounce@xxxxxxxxxxxxx <aptaoncology-bounce@xxxxxxxxxxxxx> on
behalf of Shai Sewell <ssewell1989@xxxxxxxxx>
Sent: Tuesday, July 19, 2022 2:13:49 PM
To: aptaoncology@xxxxxxxxxxxxx <aptaoncology@xxxxxxxxxxxxx>;
aptaoncpeds@xxxxxxxxxxxxx <aptaoncpeds@xxxxxxxxxxxxx>
Subject: [External] [aptaoncology] Ataxia with ALL
Good afternoon everyone. Hoping people could shed some insight on a case.
I currently have a 25 y.o. male with a PMHx of ALL with CNS involvement,
currently being treated with ponatinib daily, intrathecal methotrexate via
ommaya reservoir, and periodic IV Vincristine. He is being evaluated for ataxic
gait and paresthesias of the lower extremities. Neuro is relating the temporal
dose of his vincristine (last given on 6/22) and his current symptoms (which
started around 07/04) to his symptoms. He was hypoactive on his reflexes (both
upper and lower) as well (1+). He was cleared from CNS involvement in March,
but I am sure they will retest with an LP with these symptoms. I don't have
much experience with ALL or Vincristine, but these symptoms seem odd with such
a sudden onset. Any thoughts on whether this is common with Vincristine,
something else, or if it is more likely due to recurrence?
Thanks in advance,
Shai Sewell
