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document
Evolution of neuropathy and myopathy during intensive vincristine/corticosteroid chemotherapy for non-Hodgkin 's lymphoma . Neuropathy and myopathy are common sequelae of intensive chemotherapy protocols that contain vincristine and corticosteroids . The authors prospectively monitored the evolution of neuropathy and myopathy during an intensive 12-week chemotherapy program for patients with intermediate and high-grade non-Hodgkin 's lymphoma . In this study , vincristine was administered by bolus injection followed by a 3-day continuous intravenous ( IV ) infusion ( total dose of 2.0 mg/m2 every other week ) ; the maximum dose of vincristine was not arbitrarily limited . Cronassial , a mixture of four naturally occurring gangliosides , was administered in a randomized double-blind test to evaluate whether this agent could prevent vincristine-induced neuropathy . High doses of dexamethasone ( 50 mg/d for 3 days weekly or every other week ) were also prescribed . Patients were monitored every 4 weeks with comprehensive physical and neurologic examinations and electrophysiologic studies of peripheral nerve function . Twenty-seven patients were fully evaluable . Weakness was a prominent adverse reaction in this study , and all patients had moderate to severe signs and symptoms of neuropathy and myopathy . Cronassial ( 100 mg ) administered by intramuscular ( IM ) injection daily provided no protection against the development of neuropathic symptoms . Vincristine typically impaired fine-motor coordination initially , whereas corticosteroids were associated with delayed development of proximal muscle weakness . Results of electrodiagnostic studies did not add to the clinical examination results . The authors conclude that symptomatic weakness due to neuropathy or myopathy appears in a predictable manner during intensive vincristine/corticosteroid-based treatment protocols . Simple clinical tests can be used to rapidly distinguish between toxic effects due either to vincristine or corticosteroids , and routine implementation of these tests can prevent inappropriate dose attenuation of these agents .
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Intervention_Physical
vincristine/corticosteroid chemotherapy
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Intervention_Physical
intensive chemotherapy protocols that contain vincristine and corticosteroids
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Intervention_Physical
chemotherapy
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Intervention_Pharmacological
vincristine
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Intervention_Pharmacological
bolus
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Intervention_Pharmacological
vincristine
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Intervention_Pharmacological
Cronassial , a mixture of four naturally occurring gangliosides
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Intervention_Pharmacological
vincristine-induced
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Intervention_Pharmacological
dexamethasone
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Intervention_Pharmacological
Cronassial
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Intervention_Pharmacological
Vincristine
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Intervention_Pharmacological
corticosteroids
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Intervention_Physical
vincristine/corticosteroid-based treatment
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Intervention_Pharmacological
vincristine or corticosteroids
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Outcome_Adverse-effects
Weakness
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Outcome_Physical
moderate to severe signs and symptoms of neuropathy and myopathy
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Outcome_Physical
development of neuropathic symptoms
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Outcome_Physical
fine-motor coordination
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Outcome_Physical
development of proximal muscle weakness
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Outcome_Physical
symptomatic weakness
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Participant_Condition
intermediate and high-grade non-Hodgkin 's lymphoma
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Participant_Sample-size
Twenty-seven