ONS Connections: Pediatric vincristine-induced peripheral neuropathy reliably and validly assessed

PHOENIX—A composite measure assessed peripheral neuropathy induced by vincristine reliably and with validity, according to research presented at the Oncology Nursing Society (ONS) Connections: Advancing Care Through Science conference.

Vincristine is a mainstay treatment for pediatric leukemia that is linked to improved survival. While adequate dosing is necessary, doses are limited by vincristine-induced peripheral neuropathy (VIPN), which compromises quality and quantity of life. The dosing of vincristine is guided by reliable and valid VIPN assessment guides, but quantifying the numbness, tingling, and neuropathic pain related to VIPN is difficult in young children. Few studies have focused on testing ways to quantify neuropathy signs and symptoms.

This longitudinal, prospective study focused on the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), and sought to determine its reliability, validity, sensitivity to change, and clinical utility. The researchers obtained TNS-PV scores from 65 children over 15 weeks. The children had a median age of 7.5 years. To determine pharmacokinetics, blood was obtained 15 and 30 minutes after vincristine treatment on Day 8 of induction therapy. Three assessments were used for VIPN: TNS-PV, the Balis and National Cancer Institute Common Toxicity Criteria (NCI-CTC v. 4.0) grading scales, and the FACES pain scale.

The TNS-PV neuropathic pain had a moderate correlation with the FACES scores. While the TNS-PV was very sensitive to change, both the NCI-CTC and the FACES scales were insensitive to change. Scores for TNS-PV were attained in 96% of the children age 6 years and older, while FACES scores were attained in children of all ages. With the TNS-PV and FACES scales, reliable and valid VIPN assessments can be attained in children age 6 years and older.

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