Introduction
Vincristine is a vinca alkaloid chemotherapy agent used in the treatment
haematological malignancies including acute lymphoblastic leukaemia
(ALL) and some lymphomas. Common toxicity includes neuropathy which can
be peripheral, autonomic or less commonly central1.
Vincristine remains an essential chemotherapy agent in modern ALL
protocols1,2,3. It’s mechanism of action is by
inhibiting the M phase of mitosis by binding with the protein component
of microtubules. Axonal degeneration takes place when axonal transport
and secretory functions are impaired thus leading to apoptosis and
toxicity in neural tissue. This is typically seen within the
extra-ocular muscles and larynx in cranial
neuropathy1.
Recurrent laryngeal nerve palsy resulting in vocal cord paralysis (vcp)
in children has been documented in the literature in multiple case
reports and small number of case series4.We present
the largest case series to date of seven children who sustained vcp
secondary to vincristine chemotherapy for ALL and review the literature.