A 80-year-old male patient recently diagnosed with non-Hodgkin’s lymphoma was staed on treatment with R- CHOP chemotherapy regimen. After few days, the patient comes to the clinic with complaints of tingling in his hands and feet. Neurological examination shows symmetric “stocking and glove” type distal neuropathy. If the patient’s symptoms are believed to be due to chemotherapy regimen, the drug responsible for these symptoms causes cell cycle arrest during which of the following stages?
Correct Answer: M phase
Description: R - CHOP regimen includes Rituximab Cyclophosphamide Hydroxydaunorubicin Oncovin or vincristine Prednisolone The patient is suffering from distal symmetric neuropathy in a stocking and glove like distribution which is a characteristic side effect of vincristine, a vinca alkaloid. Vinca alkaloids: Mechanism of action: Inhibition of tubulin polymerization, which disrupts assembly of microtubules (pa of cytoskeleton) and the mitotic spindle. This inhibitory effect results in mitotic arrest in metaphase, bringing cell division to a halt, which then leads to cell death. ADVERSE EFFECTS: At clinically used (intravenous) doses, neurotoxicity: glove-and-stocking neuropathy. Acute neuropathic effects include jaw pain, paralytic ileus, urinary retention, and the SIADH secretion.
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