The neurophysiological characteristics of peripheral neuropathy in patients with acute lymphoblastic leukemia

Background: One of the most frequent side effects in ALL patients receiving neurotoxic chemotherapeutic drugs, particularly vincristine, is chemotherapy-induced peripheral neuropathy (CIPN). The diagnosis of CIPN is usually made clinically; however, electrophysiologic studies verify the diagnosis and rule out other possibilities for the neuropathic symptoms. Aims: The purpose of this study was to estimate the percentage of CIPN, as well as evaluate the neurophysiological alterations of peripheral neuropathy in ALL patients receiving chemotherapy.Methods: A multicentric cross-sectional study was carried out in southern Iraq, Basrah city. Thirty-eight patients with an established ALL diagnosis were included in the study. Their clinical and electrophysiological parameters, employing nerve conduction studies and needle electromyography, have been recorded.Results: Among ALL patients, the CIPN percentage was 26.31%. All the cases were axonal polyneuropathy; of them, 60% had pure sensory neuropathy and 40% had mixed sensory motor neuropathy. In NCS, sural nerve approached the borderline while, needle EMG demonstrated distal lower limb muscle neuropathic changes.Conclusions: The chemotherapeutic regimen utilized for ALL induced peripheral neuropathy; the pattern was distal, symmetrical, length-dependent, axonal polyneuropathy of pure sensory, followed by mixed sensory-motor type. We recommend screening routine for early detection of PN, further study to assess pre and post treatment changes with a bigger sample size and longer follow-up.