Long-term neurotoxicity in patients treated with cisplatin, vinblastine, and bleomycin for metastatic germ cell cancer. 1989

S W Hansen, and S Helweg-Larsen, and W Trojaborg
Department of Oncology, Finsen Institute, Rigshospitalet, Copenhagen, Denmark.

Thirty patients treated for germ cell cancer with six cycles of cisplatin, vinblastine, and bleomycin participated in a follow-up examination of neurotoxicity 49 to 106 months after treatment. Of these, 22 patients (73%) had sensory loss; half of them complained of paresthesias. The vibration perception threshold was increased in 24 patients (80%). Auditory stimulation revealed a normal latency of the first component of the brain stem-evoked potentials Pl but an increased interpeak interval between this and Pv; reflecting a central conduction defect. Motor conduction velocity (CV) along the peroneal nerve was normal. The average sural nerve CV was decreased (P less than .01) and the sensory action potential amplitude was reduced (P less than .01). Warm perception threshold was increased in 10 patients (33%). Cortical-evoked potentials after tibial nerve stimulation had increased latencies in 29 patients (97%). The peripheral CV along the tibial nerve was slowed (P less than .01) in 19 patients, and the central conduction time from Th12 to cortex was prolonged in 15 patients (P less than .01). The changes in conduction along peripheral and central pathways after tibial nerve stimulation are compatible with a toxic effect on the sensory root ganglia causing a "dying back" axonal degeneration of central and peripheral nerve fibers.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009422 Nervous System Diseases Diseases of the central and peripheral nervous system. This includes disorders of the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscle. Neurologic Disorders,Nervous System Disorders,Neurological Disorders,Disease, Nervous System,Diseases, Nervous System,Disorder, Nervous System,Disorder, Neurologic,Disorder, Neurological,Disorders, Nervous System,Disorders, Neurologic,Disorders, Neurological,Nervous System Disease,Nervous System Disorder,Neurologic Disorder,Neurological Disorder
D009431 Neural Conduction The propagation of the NERVE IMPULSE along the nerve away from the site of an excitation stimulus. Nerve Conduction,Conduction, Nerve,Conduction, Neural,Conductions, Nerve,Conductions, Neural,Nerve Conductions,Neural Conductions
D010292 Paresthesia Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation. Dysesthesia,Formication,Paresthesia, Distal,Paresthesia, Painful,Distal Paresthesia,Distal Paresthesias,Dysesthesias,Formications,Painful Paresthesia,Painful Paresthesias,Paresthesias,Paresthesias, Distal,Paresthesias, Painful
D010468 Perceptual Disorders Cognitive disorders characterized by an impaired ability to perceive the nature of objects or concepts through use of the sense organs. These include spatial neglect syndromes, where an individual does not attend to visual, auditory, or sensory stimuli presented from one side of the body. Hemispatial Neglect,Hemisensory Neglect,Sensory Neglect,Somatosensory Discrimination Disorder,Discrimination Disorder, Somatosensory,Discrimination Disorders, Somatosensory,Hemisensory Neglects,Hemispatial Neglects,Neglect, Hemisensory,Neglect, Hemispatial,Neglect, Sensory,Neglects, Hemisensory,Perceptual Disorder,Sensory Neglects,Somatosensory Discrimination Disorders
D010523 Peripheral Nervous System Diseases Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. Peripheral Nerve Diseases,Peripheral Neuropathies,PNS (Peripheral Nervous System) Diseases,PNS Diseases,Peripheral Nervous System Disease,Peripheral Nervous System Disorders,Nerve Disease, Peripheral,Nerve Diseases, Peripheral,Neuropathy, Peripheral,PNS Disease,Peripheral Nerve Disease,Peripheral Neuropathy
D011930 Reaction Time The time from the onset of a stimulus until a response is observed. Response Latency,Response Speed,Response Time,Latency, Response,Reaction Times,Response Latencies,Response Times,Speed, Response,Speeds, Response
D001761 Bleomycin A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. BLEO-cell,Blanoxan,Blenoxane,Bleolem,Bleomicina,Bleomycin A(2),Bleomycin A2,Bleomycin B(2),Bleomycin B2,Bleomycin Sulfate,Bleomycins,Bleomycinum Mack,Bléomycine Bellon,BLEO cell,BLEOcell,Bellon, Bléomycine,Mack, Bleomycinum,Sulfate, Bleomycin
D002945 Cisplatin An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. Platinum Diamminodichloride,cis-Diamminedichloroplatinum(II),cis-Dichlorodiammineplatinum(II),Biocisplatinum,Dichlorodiammineplatinum,NSC-119875,Platidiam,Platino,Platinol,cis-Diamminedichloroplatinum,cis-Platinum,Diamminodichloride, Platinum,cis Diamminedichloroplatinum,cis Platinum

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