VINCRISTINE NEUROPATHY IN TYPE-I AND TYPE-II CHARCOT-MARIE-TOOTH DISEASE (HEREDITARY MOTOR SENSORY NEUROPATHY)

A patient with Ewing's sarcoma and demyelinating type Charcot-Marie-To oth disease (CMT) developed severe neuropathy after receiving a total vincristine dose of 6 mg. Recovery was slow and incomplete. A second p atient with axonal type CMT developed moderate neuropathy but tolerate d extended vincristine administration and recovered quickly. Possible underlying neuropathy should be excluded before vincristine treatment is begun by careful examination including inspection of the feet, foll owed by electrophysiologic studies as indicated. In demyelinating CMT, vincristine should be avoided; in axonal form cautious use may be con sidered. (C) 1995 Wiley-Liss, Inc.