Numbness paclitaxel

Myelosuppression is the major side effect of paclitaxel. Alopecia is common, as is reversible dose-related peripheral neuropathy. Most patients have mild numbness and tingling of the fingers and toes beginning a few days after treatment. Mild muscle and joint aching also may begin 2 or 3 days after initiation of therapy. Nausea is usually mild or absent. Severe hypersensitivity reactions may occur. Cardiovascular side effects, consisting of mild hypotension and bradycardia, have been noted in up to 25% of patients. 

Peripheral neuropathy presents as numbness, burning, and tingling in a glove-and-stocking distribution. Symptoms usually begin 24-72 hours after treatment with paclitaxel, with a symmetrical distal loss of sensation. Most cases occur at doses over 200 mg/m and particularly after multiple courses (24—26). Mild to moderate sensory neuropathy has occurred in 52% of patients treated with doses of 175 mg/m, while only 36% experienced neuropathy at doses of at least 135 mg/m (17,24,28,29). At the lower dose of 135 mg/m, the effects are usually limited to a mild sensory neuropathy (17,29). 

Peripheral neuropathy presents as numbness, burning, and tingling in a glove-and-stocking distribution. Symptoms usually begin 24-72 hours after treatment with paclitaxel, with a symmetrical distal loss of sensation. Once treatment is stopped, the symptoms generally subside within several weeks to months [34 =]. 

Nervons system Most studies of albumin-bound paclitaxel have used a higher dose of paclitaxel than with Cremophor-based paclitaxel, and this has correlated with a higher incidence of peripheral neuropathy. In phase II studies, 11-38% of patients had grade 2 or worse sensory neuropathy [9T, 98, 998], In a phase II comparison of 3-weekly cycles of albumin-bound paclitaxel 260 mg/rr and conventional Cremophor-based paclitaxel 175 mg/rr, grade 3 peripheral neuropathy was reported in 10% versus 2% of cases [100 ]. Neuropathy typically occurs in a glove-and-stocking distribution, with symptoms of numbness or pain. Perioral numbness has also been reported [95 "]. No cases of motor neuropathy have been reported so far. 

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