Conclusion
Although rare, vcp is a known, potentially life threatening complication
of vinca alkaloid chemotherapy agents such as Vincristine. Recovery is
to be expected with cessation of therapy. Prompt diagnosis in terms of
low threshold for requesting laryngeal examination by an ENT specialist
can facilitate appropriate early treatment and recovery. An
individualized approach to delivery of necessary chemotherapy can
achieve both recovery of cord palsy allowing reversal of tracheostomy as
well as maintaining long term remission from leukaemia.
Key points
- We present the largest case series to date of seven patients
sustaining vocal cord paralysis after receiving vincristine
chemotherapy for acute lymphoblastic leukaemia.
- Vocal cord paralysis was only seen in children under five years
- Vocal cord paralysis appeared to be reversible following cessation of
vincristine in our case series and in other cases reported in the
literature
- Prompt referral to an ENT specialist for bedside laryngeal examination
is essential to promptly diagnose vocal cord palsy and guide
management regarding the need to continue vincristine to achieve
remission versus need for tracheostomy.