PERIPHERAL NEUROPATHY FOLLOWING HIGH-DOSE ETOPOSIDE AND AUTOLOGOUS BONE-MARROW TRANSPLANTATION

We investigated the incidence of peripheral neuropathy in 142 consecut ive patients receiving high-dose etoposide between August 1988 and Dec ember 1991. A retrospective chart review was conducted. Six patients w ith hematologic malignancies presented with a new sensory polyneuropat hy after receiving an intensive therapy regimen consisting of etoposid e 60 mg/kg iv and melphalan 140-160 mg/m(2) iv followed by autologous bone marrow transplantation. Neurologic symptoms began 2-8 weeks after transplant, were grade 2-3 in severity and pursued a chronic course w ith slow improvement over months. Electromyographic studies in three o f the patients tested confirmed distal sensory polyneuropathy. All 6 p atients had previously received vincristine 1-60 months prior to autot ransplant. We conclude that peripheral neuropathy of moderate severity is a potential complication of high-dose etoposide therapy but appear s to be self-limited.