Compression therapy using surgical gloves was ineffective for the prevention of vincristine-induced neuropathy in patients with malignant lymphoma

Compression therapy using surgical gloves was ineffective for the prevention of vincristine-induced neuropathy in patients with malignant lymphoma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Compression therapy using surgical gloves was ineffective for the prevention of vincristine-induced neuropathy in patients with malignant lymphoma Takuya Suyama, Yuri Tsuboi, Misayo Shimizu, Akihiro Kuroda, Masanori Seki, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2811473/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Feb, 2024 Read the published version in Supportive Care in Cancer → Version 1 posted 7 You are reading this latest preprint version Abstract Purpose Vincristine (VCR) often induces peripheral neuropathy (PN) as an adverse event. Currently, there is no consensus about prevention of vincristine-induced PN (VIPN). In this study, we aimed to investigate the efficacy of compression therapy using surgical gloves for preventing VIPN. Methods Patients with malignant lymphoma (vincristine-naïve) who were receiving chemotherapy with cyclophosphamide, doxorubicin, VCR, and prednisolone, with or without rituximab, every 3 weeks for six cycles were eligible. For every VCR infusion, each patient wore two one-size smaller gloves on one hand (study hand) for 90 min. The other hand was bare (control hand). PN was assessed at each treatment using common terminology criteria for adverse events ver. 4.0. Results Fifty-one patients with malignant lymphoma were enrolled and 44 were evaluated. The occurrence rates of grade ≥ 2 sensory PN were 13.6 and 13.6% in the study and control hands, respectively ( p = 1.0) at 1 month after treatment. The occurrence rates of grade ≥ 2 motor PN were 15.9 and 15.9% in the study and control hands, respectively ( p = 1.0). Conclusion Compression therapy using surgical gloves showed no significant effect for the prevention of VIPN. Trial registration First November 2018 National University Hospital Council of Japan (UMIN 000034145). Vincristine induced peripheral neuropathy CHOP chemotherapy compression therapy malignant lymphoma Figures Figure 1 Figure 2 Introduction In the treatment of malignant lymphoma, vincristine (VCR) is a key drug. It is administered in a combination chemotherapy of cyclophosphamide, doxorubicin, VCR, and prednisolone (CHOP), with or without rituximab [ 1 ]. Peripheral neuropathy (PN) is the most important non-hematological adverse event of VCR treatment, which leads to dose reductions and has a negative impact on health-related quality of life (QOL) [ 2 , 3 ]. Vincristine dose reduction due to neuropathy has been reported to impair survival outcomes in patients with diffuse large B cell lymphoma (DLBCL) [ 4 ]. Vincristine-induced neuropathy (VIPN), which is usually a peripheral sensorimotor neuropathy, occurs in 20–40% of DLBCL patients treated with CHOP with rituximab (R-CHOP) [ 5 , 6 ]. The clinical features and symptoms of VIPN range from reversible after discontinuation of VCR to irreversible neurological sequelae such as permanent loss of deep tendon reflexes, motor disorders, and handwriting difficulties [ 3 ]. ) Although many studies have been performed for prevention of VIPN, there is still no consensus [ 7 – 9 ]. On the other hand, several studies have reported that compression therapy using surgical gloves and cold therapy using frozen gloves are effective in the prevention of nanoparticle albumin-bound paclitaxel (nab-PTX)-induced PN [ 10 – 12 ]. Tsuyuki et al. reported that compression therapy using surgical gloves is a low-cost and safe method compared to cold therapy using frozen gloves [ 10 ]. Their methodology consisted of each patient wearing two one-size-smaller surgical groves on their dominant hand for 90 min from 30 min before nab-PTX infusion to 30 min after the end of the infusion. The patients did not wear surgical gloves on their other hand, and this hand was used as the control hand. They reported that the hands that underwent compression had a significantly lower occurrence rate of grade ≥ 2 PN as defined by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (76.1%: SG-compression hands, 26.2%: control hands). VCR and PTX are also known as anti-microtubule agents, which act by binding to β-tubulin. Axonal microtubules also contain β-tubulin; thus, VCR and PTX may lead to neuropathy, which impairs axoplasmic transport due to these drugs binding to microtubules, resulting in progressive dying-back axonopathy [ 13 , 14 ] We predicted that compression therapy using surgical gloves would be effective for reducing VIPN as well as nab-PTX-induced PN and have less side effects. Moreover, compression therapy could improve the QOL and relative dose intensity of patients with malignant lymphoma. In the present study, we used the same procedure as previous compression therapy studies to investigate the efficacy of compression therapy using surgical gloves to prevent VIPN. Patients And Methods This study was a prospective, single-center, self-control clinical trial, in which patients were enrolled at Hitachi General Hospital. The study population consisted of vincristine-naive patients with malignant lymphoma. Patients were recruited in the period from November 2018 to November 2021. Eligible patients were aged ≥ 20 years and had an Eastern Cooperative Oncology Group performance status of 0–2. Exclusion criteria were patients with PN grade ≥ 1 according to CTCAE and those with an allergic reaction to wearing surgical gloves. Information on clinical factors, including lymphoma-subtype, National Comprehensive Cancer Network International Prognostic Index, Ann arbor stage, and treatment, were obtained from medical records. All patients provided written informed consent. The protocol was approved by the Ethics Committees at Hitachi General Hospital. This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry managed by the National University Hospital Council of Japan (UMIN 000034145). Patients enrolled in this study were undergoing treatment for malignant lymphoma with CHOP consisting of cyclophosphamide (750 mg/m 2 /day, 1 day); doxorubicin (50 mg/m 2 /day, 1 day), vincristine (1.4 mg/m 2 /day [max 2.0 mg], 1 day); and prednisolone (100 mg/body, 5 days) ± rituximab (R; 375 mg/m 2 /day, 1 day) every 3 weeks for six cycles. At every VCR infusion, each patient wore two one-size smaller surgical gloves on one hand (study hand) for 90 min from 30 min before VCR infusion to 60 min after end of the infusion. Similar to previous studies of compression therapy for nab-PTX, we used 90 minutes as total glove-wearing time [ 9 , 10 ] The other hand did not wear gloves and was used as the control hand. Patients were randomly assigned into two groups, one group that used their dominant hand and one that used their non-dominant hand for compression therapy (one-to-one ratio). The one-size smaller surgical glove sizes were determined by a physician after the patients tried to fit surgical gloves several times. We used SIGNATURE LATEX ESSENTIAL (Medline, Malaysia) surgical gloves for all sizes. Sensory and motor PN were assessed before chemotherapy of each cycle and 1 month after chemotherapy by nurses in the chemotherapy unit using CTCAE. Patients also reported sensory and motor condition using the Patient Neurotoxicity Questionnaire (PNQ) at the same time as the CTCAE assessment. PNQ grades consisted of grade A (no neurotoxicity), grade B (mild), grade C (moderate), grade D (severe), and grade E (very severe neurotoxicity) [ 10 ]. Treatment was stopped when patients showed intolerance to the compression therapy, had serious adverse events, disease progression, or withdrew consent. Statistical analysis The primary endpoint was the difference of the incidence of grade ≥ 2 PN (motor and sensory) between the study hands and control hands as determined by the nurses in the chemotherapy unit using CTCAE at 1 month after treatment. Secondary endpoint was the difference of the incidence of grade ≥ 1 PN (motor and sensory) between the study hands and control hands using CTCAE, and the difference of the incidence of grade ≥ B PN (motor and sensory) between the study hands and control hands as determined by the patients using PNQ from the start of chemotherapy to 1 month after treatment. We planned samples by defining the frequency of grade ≥ 2 PN in the control hand as 32% as reported in a previous study [ 5 ]. There was no published data about the efficacy of compression therapy for VIPN. The previous study showed that the occurrence rate of grade ≥ 2 paclitaxel-induced PN were 76.1% (control hand) and 21.4% (compression hand). We expected a 24% difference between the two groups with 80% power and a significance level for a two-side test of 0.05, and a 5% dropout rate; thus, we planned a total sample of 51 patients. Fisher’s exact test was used to compare differences in the incidence of PN (motor and sensory) between the study hands and control hands. All statistical analyses were performed using EZR [ 15 ]. A two-sided p value < 0.05 was considered significant. Results Patients Between September 2018 and April 2021, 51 patients with malignant lymphoma were enrolled in this study. Six patients discontinued compression therapy because they could not complete the six cycles of CHOP therapy due to disease progression (four patients), delirium (one patients), and intolerance to chemotherapy (one patient). Furthermore, one patient could not tolerate compression therapy. As the result, 44 patients were evaluated. The patient characteristics are shown in Table. 1 . Median age was 73. Fifteen patients (34.9%) were administered a reduced dosage of CHOP (70%) because the patients were aged or had a performance status of 2. No patient used medications to prevent PN such as pregabalin, duloxetine, and goshajinkigan. Primary outcome CTCAE sensory and motor grades are shown in Fig. 1 . As the treatment cycles of CHOP increased, the incidence of all grades of PN also increased gradually. At 1 month after treatment, six patients (13.6%) developed CTCAE grade ≥ 2 sensory PN in their study hands and six patients (13.6%) developed grade ≥ 2 sensory PN in control hands ( p = 1.0). Seven patients (15.9%) developed grade ≥ 2 motor PN in their study hands and seven patients (15.9%) developed grade ≥ 2 motor PN in their control hands ( p = 1.0). This study found no significant difference in grade ≥ 2 sensory and motor PN between the study hands and the control hands. Secondary outcome Thirty patients (68.2%) developed CTCAE grade ≥ 1 sensory PN in their study hands and thirty-three patients (75.0%) developed grade ≥ 1 sensory PN in their control hands ( p = 0.64) from the start of chemotherapy to 1 month after treatment. Twenty-three patients (52.3%) developed grade ≥ 1 motor PN in their study hands and twenty-four patients (54.5%) developed grade ≥ 1 motor PN in control hands ( p = 1.0). PNQ sensory and motor grade are shown in Fig. 2 . Twenty-nine patients (65.9%) developed PNQ grade ≥ B sensory PN in their study hands and 33 patients (75.0%) developed grade ≥ B sensory PN in their control hands ( p = 0.48) from the start of chemotherapy to 1 month after treatment. Twenty-four patients (54.5%) developed grade ≥ B motor PN in their study hands and 27 patients (61.4%) developed grade ≥ B motor PN in control hands ( p = 0.67). There was no significant difference between the study hands and the control hands. Discussion Our findings suggest that compression therapy using surgical gloves was not effective in preventing the incidence of VIPN for both primary and secondary endpoints using the same procedure as previous compression therapy reports of nab-PTX. VIPN is one of the major adverse events of CHOP therapy. A prospective study in Korea showed that 84.4% of patients with DLBCL or follicular lymphoma treated with R-CHOP had sensory neuropathy [ 16 ]. The study reported that patients with neuropathy showed worse QOL associated with physical health status than patients without neuropathy. A retrospective analysis in Japan reported that patients who reduced vincristine dose due to neuropathy had worse survival outcome than those who did not [ 4 ]. There have been many studies on the prevention of VIPN; however, there is no consensus. In two double-blind, randomized, placebo-control studies for VIPN performed in the USA, one study found that patients who took oral glutamine daily during chemotherapy, which included vincristine, had decreased significant sensory neuropathy; on the other hand, the other study reported that oral glutamine had no effect on prevention of VIPN [ 7 , 8 ]. Furthermore, three small studies reported that treatment with pyridoxine (vitamin B6) and pyridostigmine (an acetylcholinesterase inhibitor) improved symptoms of VIPN in children; however, all the studies were small and single-arm studies [ 17 – 19 ]. In the present study, compression therapy using surgical gloves was ineffective in preventing VIPN. Compression therapy using surgical gloves has been reported to be effective in preventing nab-PTX-induced PN, as compression therapy using surgical gloves prevents PN by decreasing the microvascular flow to each fingertip by compression and cold-induced vasoconstriction [ 10 , 20 ]. On the other hand, a recent double-blind phase 2 trial showed that compression therapy using surgical gloves did not prevent paclitaxel (PTX)-induced PN [ 21 ]. This trial had very stringent protocol to reduce bias. Thus, compression therapy is effective for preventing nab-PTX-induced PN but may not be effective in preventing PTX and VCR-induced PN. Besides the chemotherapy agent, there are several differences between our study and previous studies. First, previous study populations consisted entirely of females with breast cancer, whereas our study included both males and females with malignant lymphoma. Second, the incidence of grade ≥ 2 nab-PTX-induced PN is higher than the incidence with VCR; thus, the result of compression therapy in our study may have been due to the difference in PN incidence between nab-PTX and VCR. Third, in our study, 15 patients (34.9%) were administered a reduced dosage of CHOP (about 70%). A previous review reported that higher VCR doses led to severe neuropathy [ 22 ]. Although the cumulative incidence of grade ≥ 2 VIPN in our study was the same as previous study [ 5 ], the reduction of doses of CHOP may have affected the result. Our trial had several limitations. First, we did not measure differences in fingertip temperatures between the study hands and control hands. Previous studies reported that compression therapy is effective for preventing the nab-PTX-induced PN caused by decreasing the microvascular flow to each fingertip by compression and cold-induced vasoconstriction [ 10 , 16 ]. These studies reported that compression therapy decreased the temperature of the fingertips. We followed the methodology of previous studies of compression therapy; however, we did not measure the temperature of each fingertip. Second, as the study participants and physicians were not blinded, this may have allowed performance bias and detection bias. Third, we only evaluated PN by subjective methods such as CTCAE and PNQ. More objective assessment methods are needed to evaluate PN in future studies. Fourth, sample size was lower than expected due to discontinuation of chemotherapy. Conclusion In summary, we evaluated the efficacy of compression therapy using surgical gloves to prevent VIPN. In our study, compression therapy was not effective for decreasing the incidence of VIPN. Further studies are required to assess the efficacy of novel approaches. Declarations Acknowledgements We thank the many nurses and patients of Hitachi General Hospital. Funding The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Competing interests The authors have no relevant financial or non-financial interests to disclose. Author contributions All authors contributed to study conception and design. Data preparation and analysis were performed by Takuya Suyama. Data collection was performed by all authors. The first draft of the manuscript was written by Takuya Suyama, Yuri Tsuboi, Misayo Shimizu. Akihiro Kuroda, Masanori Seki, Atsushi Shinagawa commented on previous versions of the manuscript. All authors read and approved the final manuscript. Ethics approval Approval was obtained from the ethics committee of Hitachi General Hospital. The procedures used in this study adhere to the tenets of Declaration of Helsinki. Consent to participate Informed consent to participate was obtained prior to intervention commencement from all participants. Consent for publication Informed consent to publish data was obtained from participants. References Sehn LH, Donaldso J, Chhanabhai M, Fitzgerald C, Gill K, Klasa R, et al (2005) Introduction of combined CHOP plus rituximab therapy dramatically improved outcome of diffuse large B-cell lymphoma in British Columbia. J Clin Oncol. 25: 5027-5033. doi: 10.1200/JCO.2005.09.137 Sawaki A, Miyazaki K, Yamaguchi M, Takeuchi T, Kobayashi K, Imai H, et al (2020) Genetic polymorphisms and vincristine-induced peripheral neuropathy in patients treated with rituximab, cyclophosphamide, doxorubicin, and prednisone therapy. Int J Hematol. 111: 686-691. doi: 10.1007/s12185-020-02832-x Tay CG, Lee VWM, Ong LC, Goh KJ, Ariffin H, Fong CY (2017) Vincristine-induced peripheral neuropathy in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 64: doi: 10.1002/pbc.26471 Utsu Y, Takaishi K, Inagaki S, Arai H, Yuasa H, Masuda S, et al (2016) Influence of dose reduction of vincristine in R-CHOP on outcomes of diffuse large B cell lymphoma. Ann Hematol. 95: 41-47. doi: 10.1007/s00277-015-2514-9 Hatzl S, Posch F, Rezai A, Gornicec M, Beham-Schmid C, Magnes T, et al (2021) Vinorelbine as substitute for vincristine in patients with diffuse large B cell lymphoma and vincristine-induced neuropathy. Support Care Cancer. 29: 5197-5207. doi: 10.1007/s00520-021-06059-2 Saito T, Okamura A, Inoue J, Makiura D, Doi H, Yakushijin K, et al (2019) Anemia Is a Novel Predictive Factor for the Onset of Severe Chemotherapy-Induced Peripheral Neuropathy in Lymphoma Patients Receiving Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone Therapy. Oncol Res. 27: 469-474. doi: 10.3727/096504018X15267574931782 Sands S, Ladas EJ, Kelly KM, Weiner M, Lin M, Ndao DH, et al (2017) Glutamine for the treatment of vincristine-induced neuropathy in children and adolescents with cancer. Support Care Cancer. 25: 701-708. doi: 10.1007/s00520-016-3441-6 Bradfield SM, Sandler E, Geller T, Tamura RN, Krischer JP (2015) Glutamic acid not beneficial for the prevention of vincristine neurotoxicity in children with cancer. Pedeatr Blood Cancer. 62: 1004-1010. doi: 10.1002/pbc.25384 Beijers AJ, Jongen JL, Vreugdenhil G (2012) Chemotherapy-induced neurotoxicity: the value of neuroprotective strategies. Neth J Med. 70: 18-25. Tsuyuki S, Senda N, Kanng Y, Yamaguchi A, Yoshibayashi H, Kikawa Y, et al (2016) Evaluation of the effect of compression therapy using surgical gloves on nanoparticle albumin-bound paclitaxel-induced peripheral neuropathy: a phase 2 multicenter study by the Kamigata Brest Cancer Study Group. Breast Cancer Res Treat. 160: 61-67. doi: 10.1007/s10549-016-3977-7 Tsuyuki S, Yamagami K, Yoshibayashi H, Sugie T, Mizuno Y, Tanaka S, et al (2019) Effectiveness and safety of surgical glove compression therapy as a prophylactic method against nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy. 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Neurology. 64: 1076-1077. doi: 10.1212/01.WNL.0000154642.45474.28 Tables Table 1 Patient characteristics Median age(years) 73(45–86) International Prognostic Index low 1(2%) Male 23(53%) low-intermediate 11(25%) high-intermediate 24(55%) ECOG performance high 8(18%) 0 26(59%) 1 12(27%) Compression hand 2 6(14%) dominant 24(55%) non-dominant 20(45%) Disease type Diffuse large B-cell lymphoma 35(80%) Glove size Follicular lymphoma 4(9%) 5.5 17(39%) Intravascular lymphoma 3(7%) 6 11(25%) Mantle cell lymphoma 1(2%) 6.5 10(23%) Peripheral T-cell lymphoma 1(2%) 7 6(14%) Ann Arbor stage Treatment 1 4(9%) CHOP 1(2%) 2 8(18%) R-CHOP 43(98%) 3 11(25%) 4 21(48%) Dosage of CHOP 70% 15(34%) 100% 29(66%) Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 20 Feb, 2024 Read the published version in Supportive Care in Cancer → Version 1 posted Editorial decision: Major revision 02 Aug, 2023 Reviews received at journal 17 Jul, 2023 Reviewers agreed at journal 24 May, 2023 Reviewers invited by journal 21 May, 2023 Editor assigned by journal 21 May, 2023 Submission checks completed at journal 18 Apr, 2023 First submitted to journal 13 Apr, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2811473","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":192870898,"identity":"3247b9c6-3d48-4bd4-aa8a-e5717cb14e99","order_by":0,"name":"Takuya Suyama","email":"data:image/png;base64,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","orcid":"","institution":"Kanmon Medical Center","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Takuya","middleName":"","lastName":"Suyama","suffix":""},{"id":192870899,"identity":"05dc6743-c206-46a4-81d6-9b7b3b7ec4ab","order_by":1,"name":"Yuri Tsuboi","email":"","orcid":"","institution":"Hitachi General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yuri","middleName":"","lastName":"Tsuboi","suffix":""},{"id":192870900,"identity":"a94044f2-f62d-45a9-a7a7-6c1a22d40f6d","order_by":2,"name":"Misayo Shimizu","email":"","orcid":"","institution":"Hitachi General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Misayo","middleName":"","lastName":"Shimizu","suffix":""},{"id":192870901,"identity":"f6c24577-7831-4df7-a774-8d3decd4238e","order_by":3,"name":"Akihiro Kuroda","email":"","orcid":"","institution":"Hitachi General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Akihiro","middleName":"","lastName":"Kuroda","suffix":""},{"id":192870902,"identity":"66adb959-a133-496c-8878-5c6f48d8d8b5","order_by":4,"name":"Masanori Seki","email":"","orcid":"","institution":"Hitachi General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Masanori","middleName":"","lastName":"Seki","suffix":""},{"id":192870903,"identity":"33ebb346-afb9-44e6-8d09-18c0e98d8722","order_by":5,"name":"Atsushi Shinagawa","email":"","orcid":"","institution":"Hitachi General Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Atsushi","middleName":"","lastName":"Shinagawa","suffix":""}],"badges":[],"createdAt":"2023-04-13 07:59:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2811473/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2811473/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00520-024-08389-3","type":"published","date":"2024-02-20T15:01:18+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":36065591,"identity":"73b0ed09-4a44-4815-ac16-ad5fd80ac222","added_by":"auto","created_at":"2023-04-20 13:44:44","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":738437,"visible":true,"origin":"","legend":"\u003cp\u003eCTCAE grade:\u003cstrong\u003e \u003c/strong\u003edifference in the grade of peripheral neuropathy (sensory/ motor) using CTCAE ver. 4.0. \u003cstrong\u003ea \u003c/strong\u003eSensory PN. \u003cstrong\u003eb\u003c/strong\u003e Motor PN. Results are shown for the study hands and control hands in each cycle of-chemotherapy and final point. At the final point, ≥ 2 sensory PN is observed in 13.6 and 13.6% patients on the study and control side, respectively (\u003cem\u003ep\u003c/em\u003e = 1.0). Motor PN is observed in 15.9 and 15.9% patients on the study and control side, respectively (\u003cem\u003ep\u003c/em\u003e = 1.0).\u003c/p\u003e\n\u003cp\u003eCTCAE, common terminology criteria for adverse events; PN, peripheral neuropathy\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-2811473/v1/0b343dda13b3b4b9b13aa6ed.jpeg"},{"id":36065590,"identity":"41645871-ce4f-4cf6-aef4-203a24a29b67","added_by":"auto","created_at":"2023-04-20 13:44:44","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":720977,"visible":true,"origin":"","legend":"\u003cp\u003ePNQ grade: difference in the grade of peripheral neuropathy (sensory/motor) using PNQ. \u003cstrong\u003ea\u003c/strong\u003e Sensory PN. \u003cstrong\u003eb\u003c/strong\u003eMotor PN. Overall, ≥ B sensory PN is observed in 65.9 and 75% patients on the study and control sides, respectively (\u003cem\u003ep\u003c/em\u003e = 0.48). Motor PN is observed in 54.5 and 61.4% patients on the study and control side, respectively (\u003cem\u003ep\u003c/em\u003e = 0.67)\u003c/p\u003e\n\u003cp\u003ePNQ, Patient Neurotoxicity Questionnaire; PN, peripheral neuropathy\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-2811473/v1/18140e2ff77ed019a24dc0a4.jpeg"},{"id":51648304,"identity":"8b1086e9-5a5a-4e96-b5ec-c1c2ce91fb49","added_by":"auto","created_at":"2024-02-26 15:12:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":510236,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2811473/v1/a5b8eebc-b850-43ad-8cff-68bf5e6c37e1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Compression therapy using surgical gloves was ineffective for the prevention of vincristine-induced neuropathy in patients with malignant lymphoma","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn the treatment of malignant lymphoma, vincristine (VCR) is a key drug. It is administered in a combination chemotherapy of cyclophosphamide, doxorubicin, VCR, and prednisolone (CHOP), with or without rituximab [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Peripheral neuropathy (PN) is the most important non-hematological adverse event of VCR treatment, which leads to dose reductions and has a negative impact on health-related quality of life (QOL) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Vincristine dose reduction due to neuropathy has been reported to impair survival outcomes in patients with diffuse large B cell lymphoma (DLBCL) [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eVincristine-induced neuropathy (VIPN), which is usually a peripheral sensorimotor neuropathy, occurs in 20\u0026ndash;40% of DLBCL patients treated with CHOP with rituximab (R-CHOP) [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The clinical features and symptoms of VIPN range from reversible after discontinuation of VCR to irreversible neurological sequelae such as permanent loss of deep tendon reflexes, motor disorders, and handwriting difficulties [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003csup\u003e)\u003c/sup\u003e Although many studies have been performed for prevention of VIPN, there is still no consensus [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOn the other hand, several studies have reported that compression therapy using surgical gloves and cold therapy using frozen gloves are effective in the prevention of nanoparticle albumin-bound paclitaxel (nab-PTX)-induced PN [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Tsuyuki et al. reported that compression therapy using surgical gloves is a low-cost and safe method compared to cold therapy using frozen gloves [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Their methodology consisted of each patient wearing two one-size-smaller surgical groves on their dominant hand for 90 min from 30 min before nab-PTX infusion to 30 min after the end of the infusion. The patients did not wear surgical gloves on their other hand, and this hand was used as the control hand. They reported that the hands that underwent compression had a significantly lower occurrence rate of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 PN as defined by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 (76.1%: SG-compression hands, 26.2%: control hands).\u003c/p\u003e \u003cp\u003eVCR and PTX are also known as anti-microtubule agents, which act by binding to β-tubulin. Axonal microtubules also contain β-tubulin; thus, VCR and PTX may lead to neuropathy, which impairs axoplasmic transport due to these drugs binding to microtubules, resulting in progressive dying-back axonopathy [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eWe predicted that compression therapy using surgical gloves would be effective for reducing VIPN as well as nab-PTX-induced PN and have less side effects. Moreover, compression therapy could improve the QOL and relative dose intensity of patients with malignant lymphoma.\u003c/p\u003e \u003cp\u003eIn the present study, we used the same procedure as previous compression therapy studies to investigate the efficacy of compression therapy using surgical gloves to prevent VIPN.\u003c/p\u003e \u003c/div\u003e"},{"header":"Patients And Methods","content":"\u003cp\u003eThis study was a prospective, single-center, self-control clinical trial, in which patients were enrolled at Hitachi General Hospital. The study population consisted of vincristine-naive patients with malignant lymphoma. Patients were recruited in the period from November 2018 to November 2021. Eligible patients were aged\u0026thinsp;\u0026ge;\u0026thinsp;20 years and had an Eastern Cooperative Oncology Group performance status of 0\u0026ndash;2. Exclusion criteria were patients with PN grade\u0026thinsp;\u0026ge;\u0026thinsp;1 according to CTCAE and those with an allergic reaction to wearing surgical gloves. Information on clinical factors, including lymphoma-subtype, National Comprehensive Cancer Network International Prognostic Index, Ann arbor stage, and treatment, were obtained from medical records. All patients provided written informed consent. The protocol was approved by the Ethics Committees at Hitachi General Hospital. This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry managed by the National University Hospital Council of Japan (UMIN 000034145).\u003c/p\u003e \u003cp\u003ePatients enrolled in this study were undergoing treatment for malignant lymphoma with CHOP consisting of cyclophosphamide (750 mg/m\u003csup\u003e2\u003c/sup\u003e/day, 1 day); doxorubicin (50 mg/m\u003csup\u003e2\u003c/sup\u003e/day, 1 day), vincristine (1.4 mg/m\u003csup\u003e2\u003c/sup\u003e/day [max 2.0 mg], 1 day); and prednisolone (100 mg/body, 5 days)\u0026thinsp;\u0026plusmn;\u0026thinsp;rituximab (R; 375 mg/m\u003csup\u003e2\u003c/sup\u003e/day, 1 day) every 3 weeks for six cycles. At every VCR infusion, each patient wore two one-size smaller surgical gloves on one hand (study hand) for 90 min from 30 min before VCR infusion to 60 min after end of the infusion. Similar to previous studies of compression therapy for nab-PTX, we used 90 minutes as total glove-wearing time [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] The other hand did not wear gloves and was used as the control hand. Patients were randomly assigned into two groups, one group that used their dominant hand and one that used their non-dominant hand for compression therapy (one-to-one ratio). The one-size smaller surgical glove sizes were determined by a physician after the patients tried to fit surgical gloves several times. We used SIGNATURE LATEX ESSENTIAL (Medline, Malaysia) surgical gloves for all sizes.\u003c/p\u003e \u003cp\u003eSensory and motor PN were assessed before chemotherapy of each cycle and 1 month after chemotherapy by nurses in the chemotherapy unit using CTCAE. Patients also reported sensory and motor condition using the Patient Neurotoxicity Questionnaire (PNQ) at the same time as the CTCAE assessment. PNQ grades consisted of grade A (no neurotoxicity), grade B (mild), grade C (moderate), grade D (severe), and grade E (very severe neurotoxicity) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Treatment was stopped when patients showed intolerance to the compression therapy, had serious adverse events, disease progression, or withdrew consent.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe primary endpoint was the difference of the incidence of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 PN (motor and sensory) between the study hands and control hands as determined by the nurses in the chemotherapy unit using CTCAE at 1 month after treatment. Secondary endpoint was the difference of the incidence of grade\u0026thinsp;\u0026ge;\u0026thinsp;1 PN (motor and sensory) between the study hands and control hands using CTCAE, and the difference of the incidence of grade\u0026thinsp;\u0026ge;\u0026thinsp;B PN (motor and sensory) between the study hands and control hands as determined by the patients using PNQ from the start of chemotherapy to 1 month after treatment.\u003c/p\u003e \u003cp\u003eWe planned samples by defining the frequency of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 PN in the control hand as 32% as reported in a previous study [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. There was no published data about the efficacy of compression therapy for VIPN. The previous study showed that the occurrence rate of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 paclitaxel-induced PN were 76.1% (control hand) and 21.4% (compression hand). We expected a 24% difference between the two groups with 80% power and a significance level for a two-side test of 0.05, and a 5% dropout rate; thus, we planned a total sample of 51 patients.\u003c/p\u003e \u003cp\u003eFisher\u0026rsquo;s exact test was used to compare differences in the incidence of PN (motor and sensory) between the study hands and control hands.\u003c/p\u003e \u003cp\u003eAll statistical analyses were performed using EZR [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. A two-sided \u003cem\u003ep\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant.\u003c/p\u003e "},{"header":"Results","content":"\u003cp\u003ePatients\u003c/p\u003e\n\u003cp\u003eBetween September 2018 and April 2021, 51 patients with malignant lymphoma were enrolled in this study. Six patients discontinued compression therapy because they could not complete the six cycles of CHOP therapy due to disease progression (four patients), delirium (one patients), and intolerance to chemotherapy (one patient). Furthermore, one patient could not tolerate compression therapy. As the result, 44 patients were evaluated. The patient characteristics are shown in \u003cstrong\u003eTable. 1\u003c/strong\u003e. Median age was 73. Fifteen patients (34.9%) were administered a reduced dosage of CHOP (70%) because the patients were aged or had a performance status of 2.\u003c/p\u003e\n\u003cp\u003eNo patient used medications to prevent PN such as pregabalin, duloxetine, and goshajinkigan.\u003c/p\u003e\n\u003cp\u003ePrimary outcome\u003c/p\u003e\n\u003cp\u003eCTCAE sensory and motor grades are shown in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. As the treatment cycles of CHOP increased, the incidence of all grades of PN also increased gradually.\u003c/p\u003e\n\u003cp\u003eAt 1 month after treatment, six patients (13.6%) developed CTCAE grade\u0026thinsp;\u0026ge;\u0026thinsp;2 sensory PN in their study hands and six patients (13.6%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;2 sensory PN in control hands (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.0). Seven patients (15.9%) developed grade\u0026thinsp;\u003cstrong\u003e\u0026ge;\u003c/strong\u003e\u0026thinsp;2 motor PN in their study hands and seven patients (15.9%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;2 motor PN in their control hands (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.0). This study found no significant difference in grade\u0026thinsp;\u0026ge;\u0026thinsp;2 sensory and motor PN between the study hands and the control hands.\u003c/p\u003e\n\u003cp\u003eSecondary outcome\u003c/p\u003e\n\u003cp\u003eThirty patients (68.2%) developed CTCAE grade\u0026thinsp;\u0026ge;\u0026thinsp;1 sensory PN in their study hands and thirty-three patients (75.0%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;1 sensory PN in their control hands (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.64) from the start of chemotherapy to 1 month after treatment. Twenty-three patients (52.3%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;1 motor PN in their study hands and twenty-four patients (54.5%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;1 motor PN in control hands (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.0).\u003c/p\u003e\n\u003cp\u003ePNQ sensory and motor grade are shown in Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003eTwenty-nine patients (65.9%) developed PNQ grade\u0026thinsp;\u0026ge;\u0026thinsp;B sensory PN in their study hands and 33 patients (75.0%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;B sensory PN in their control hands (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.48) from the start of chemotherapy to 1 month after treatment. Twenty-four patients (54.5%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;B motor PN in their study hands and 27 patients (61.4%) developed grade\u0026thinsp;\u0026ge;\u0026thinsp;B motor PN in control hands (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.67). There was no significant difference between the study hands and the control hands.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur findings suggest that compression therapy using surgical gloves was not effective in preventing the incidence of VIPN for both primary and secondary endpoints using the same procedure as previous compression therapy reports of nab-PTX.\u003c/p\u003e \u003cp\u003eVIPN is one of the major adverse events of CHOP therapy. A prospective study in Korea showed that 84.4% of patients with DLBCL or follicular lymphoma treated with R-CHOP had sensory neuropathy [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The study reported that patients with neuropathy showed worse QOL associated with physical health status than patients without neuropathy. A retrospective analysis in Japan reported that patients who reduced vincristine dose due to neuropathy had worse survival outcome than those who did not [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. There have been many studies on the prevention of VIPN; however, there is no consensus. In two double-blind, randomized, placebo-control studies for VIPN performed in the USA, one study found that patients who took oral glutamine daily during chemotherapy, which included vincristine, had decreased significant sensory neuropathy; on the other hand, the other study reported that oral glutamine had no effect on prevention of VIPN [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Furthermore, three small studies reported that treatment with pyridoxine (vitamin B6) and pyridostigmine (an acetylcholinesterase inhibitor) improved symptoms of VIPN in children; however, all the studies were small and single-arm studies [\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the present study, compression therapy using surgical gloves was ineffective in preventing VIPN. Compression therapy using surgical gloves has been reported to be effective in preventing nab-PTX-induced PN, as compression therapy using surgical gloves prevents PN by decreasing the microvascular flow to each fingertip by compression and cold-induced vasoconstriction [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. On the other hand, a recent double-blind phase 2 trial showed that compression therapy using surgical gloves did not prevent paclitaxel (PTX)-induced PN [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This trial had very stringent protocol to reduce bias. Thus, compression therapy is effective for preventing nab-PTX-induced PN but may not be effective in preventing PTX and VCR-induced PN.\u003c/p\u003e \u003cp\u003eBesides the chemotherapy agent, there are several differences between our study and previous studies. First, previous study populations consisted entirely of females with breast cancer, whereas our study included both males and females with malignant lymphoma. Second, the incidence of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 nab-PTX-induced PN is higher than the incidence with VCR; thus, the result of compression therapy in our study may have been due to the difference in PN incidence between nab-PTX and VCR. Third, in our study, 15 patients (34.9%) were administered a reduced dosage of CHOP (about 70%). A previous review reported that higher VCR doses led to severe neuropathy [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Although the cumulative incidence of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 VIPN in our study was the same as previous study [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], the reduction of doses of CHOP may have affected the result.\u003c/p\u003e \u003cp\u003eOur trial had several limitations. First, we did not measure differences in fingertip temperatures between the study hands and control hands. Previous studies reported that compression therapy is effective for preventing the nab-PTX-induced PN caused by decreasing the microvascular flow to each fingertip by compression and cold-induced vasoconstriction [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These studies reported that compression therapy decreased the temperature of the fingertips. We followed the methodology of previous studies of compression therapy; however, we did not measure the temperature of each fingertip. Second, as the study participants and physicians were not blinded, this may have allowed performance bias and detection bias. Third, we only evaluated PN by subjective methods such as CTCAE and PNQ. More objective assessment methods are needed to evaluate PN in future studies. Fourth, sample size was lower than expected due to discontinuation of chemotherapy.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, we evaluated the efficacy of compression therapy using surgical gloves to prevent VIPN. In our study, compression therapy was not effective for decreasing the incidence of VIPN. Further studies are required to assess the efficacy of novel approaches.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank the many nurses and patients of Hitachi General Hospital.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to study conception and design. Data preparation and analysis were performed by Takuya Suyama. Data collection was performed by all authors. The first draft of the manuscript was written by Takuya Suyama, Yuri Tsuboi, Misayo Shimizu. Akihiro Kuroda, Masanori Seki, Atsushi Shinagawa commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval was obtained from the ethics committee of Hitachi General Hospital. The procedures used in this study adhere to the tenets of Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent to participate was obtained prior to intervention commencement from all participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent to publish data was obtained from participants.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSehn LH, Donaldso J, Chhanabhai M, Fitzgerald C, Gill K, Klasa R, et al (2005) Introduction of combined CHOP plus rituximab therapy dramatically improved outcome of diffuse large B-cell lymphoma in British Columbia. J Clin Oncol. 25: 5027-5033. doi: 10.1200/JCO.2005.09.137\u003c/li\u003e\n \u003cli\u003eSawaki A, Miyazaki K, Yamaguchi M, Takeuchi T, Kobayashi K, Imai H, et al (2020) Genetic polymorphisms and vincristine-induced peripheral neuropathy in patients treated with rituximab, cyclophosphamide, doxorubicin, and prednisone therapy. Int J Hematol. 111: 686-691.\u0026nbsp;doi: 10.1007/s12185-020-02832-x\u003c/li\u003e\n \u003cli\u003eTay CG, Lee VWM, Ong LC, Goh KJ, Ariffin H, Fong CY (2017) Vincristine-induced peripheral neuropathy in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 64: doi: 10.1002/pbc.26471\u003c/li\u003e\n \u003cli\u003eUtsu Y, Takaishi K, Inagaki S, Arai H, Yuasa H, Masuda S, et al (2016) Influence of dose reduction of vincristine in R-CHOP on outcomes of diffuse large B cell lymphoma. 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Support Care Cancer. 25: 701-708.\u0026nbsp;doi: 10.1007/s00520-016-3441-6\u003c/li\u003e\n \u003cli\u003eBradfield SM, Sandler E, Geller T, Tamura RN, Krischer JP (2015) Glutamic acid not beneficial for the prevention of vincristine neurotoxicity in children with cancer. Pedeatr Blood Cancer. 62: 1004-1010.\u0026nbsp;doi: 10.1002/pbc.25384\u003c/li\u003e\n \u003cli\u003eBeijers AJ, Jongen JL, Vreugdenhil G (2012) Chemotherapy-induced neurotoxicity: the value of neuroprotective strategies. Neth J Med. 70: 18-25.\u003c/li\u003e\n \u003cli\u003eTsuyuki S, Senda N, Kanng Y, Yamaguchi A, Yoshibayashi H, Kikawa Y, et al (2016) Evaluation of the effect of compression therapy using surgical gloves on nanoparticle albumin-bound paclitaxel-induced peripheral neuropathy: a phase 2 multicenter study by the Kamigata Brest Cancer Study Group. Breast Cancer Res Treat. 160: 61-67.\u0026nbsp;doi: 10.1007/s10549-016-3977-7\u003c/li\u003e\n \u003cli\u003eTsuyuki S, Yamagami K, Yoshibayashi H, Sugie T, Mizuno Y, Tanaka S, et al (2019) Effectiveness and safety of surgical glove compression therapy as a prophylactic method against nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy. Breast. 47: 22-27.\u0026nbsp;doi: 10.1016/j.breast.2019.06.008\u003c/li\u003e\n \u003cli\u003eEckhoff L, Knoop AS, Jensen MB, Ejlertsen B, Ewertz M (2013) Risk of docetaxel-induced peripheral neuropathy among 1725 Danish patients with early stage breast cancer. Breast Cancer Res Treat. 142: 109-118.\u0026nbsp;doi: 10.1007/s10549-013-2728-2\u003c/li\u003e\n \u003cli\u003eZajączkowska R, Kocot-Kępska M, Leppert W, Wrzosek A, Mika J, Wordliczek J (2019) Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. Int J Mol Sci. 20: 1451.\u0026nbsp;doi: 10.3390/ijms20061451\u003c/li\u003e\n \u003cli\u003eSiau C, Xiao W, Bennett GJ (2006) Paclitaxel- and vincristine-evoked painful peripheral neuropathies: Loss of epidermal innervation of Langerhans cells. Exp neurol. 201: 507-514.\u0026nbsp;doi: 10.1016/j.expneurol.2006.05.007\u003c/li\u003e\n \u003cli\u003eKanda Y (2013) Investigation of the freely available easy-to use software \u0026lsquo;EZR\u0026rsquo; for medical statistics. Bone Marrow Transplant. 48: 452-458.\u0026nbsp;doi: 10.1038/bmt.2012.244\u003c/li\u003e\n \u003cli\u003eKim BJ, Park HR, Roh HJ, Jeong DS, Kim BS, Park KW, et al (2010) Chemotherapy-related polyneuropathy may deteriorate duality of life in patients with B-cell lymphoma. Qual Life Res. 19: 1097-1103.\u0026nbsp;doi: 10.1007/s11136-010-9670-0\u003c/li\u003e\n \u003cli\u003eMuller L, Kramm CM, Tenenbaum T, Wessalowski R, Gobel U (2004) Treatment of vincristine-induced bilateral ptosis with pyridoxine and pyridosigmine. Pediatr Blood Cancer. 42; 287-288.\u0026nbsp;doi: 10.1002/pbc.10301\u003c/li\u003e\n \u003cli\u003eAkbayram S, Akgun C, Doğan M, Sayin R, Caksen H, Oner AF (2010) Use of pyridoxine and pyridostigmine in children with vincristine-induced neurotoxicity. Indian J Pediatr. 77: 681-683.\u0026nbsp;doi: 10.1007/s12098-010-0096-z\u003c/li\u003e\n \u003cli\u003eAydin K\u0026ouml;ker S, G\u0026ouml;zmen S, Demirağ B, \u0026Uuml;nalp A, Karapinar TH, Oymak Y, et al (2021) Effect of pyridoxine plus pyridostigmine treatment on vincristine-induced peripheral neuropathy in pediatric patients with acute lymphoblastic leukemia: a single-center experience. Neurol Sci. 42: 3681-3686.\u0026nbsp;doi: 10.1007/s10072-020-04970-w\u003c/li\u003e\n \u003cli\u003eOhno T, Mine T, Yoshioka H, Kosaka M, Matsuda S, De Kerckhove M, et al (2014) Management of peripheral neuropathy induced by nab-paclitaxel treatment for breast cancer. Anticancer Res. 34: 4213-4216.\u003c/li\u003e\n \u003cli\u003eKotani H, Terada M, Mori M, Horisawa N, Sugino K, Kataoka A, et al (2021) Compression therapy using surgical gloves does not prevent paclitaxel-induced peripheral neuropathy: results from a doubled-blind phase 2 trial. BMC Cancer. 21:548.\u0026nbsp;doi: 10.1186/s12885-021-08240-6\u003c/li\u003e\n \u003cli\u003eVerstappen CC, Koeppen S, Heimans JJ, Huijgens PC, Scheulen ME, Strumberg D, et al (2005) Dose-related vincristine-induced peripheral neuropathy with unexpected off-therapy worsening. Neurology. 64: 1076-1077. doi: 10.1212/01.WNL.0000154642.45474.28\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":" \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cdiv class=\"SimplePara\"\u003ePatient characteristics\u003c/div\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e 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class=\"SimplePara\"\u003ehigh-intermediate\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e24(55%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eECOG performance\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003ehigh\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e8(18%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e0\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e26(59%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e12(27%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eCompression hand\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e6(14%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003edominant\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e24(55%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003enon-dominant\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e20(45%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eDisease type\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eDiffuse large B-cell lymphoma\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e35(80%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eGlove size\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eFollicular lymphoma\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e4(9%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e5.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e17(39%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eIntravascular lymphoma\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e3(7%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e6\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e11(25%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eMantle cell lymphoma\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e1(2%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e6.5\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e10(23%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003ePeripheral T-cell lymphoma\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e1(2%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e7\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e6(14%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eAnn Arbor stage\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eTreatment\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e1\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e4(9%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eCHOP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e1(2%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e2\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e8(18%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eR-CHOP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e43(98%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e3\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e11(25%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003e4\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003e21(48%)\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003eDosage of CHOP\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e70%\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e15(34%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cdiv class=\"SimplePara\"\u003e100%\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cdiv class=\"SimplePara\"\u003e29(66%)\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003cbr/\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"supportive-care-in-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jscc","sideBox":"Learn more about [Supportive Care in Cancer](https://www.springer.com/journal/520)","snPcode":"520","submissionUrl":"https://submission.nature.com/new-submission/520/3","title":"Supportive Care in Cancer","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Vincristine induced peripheral neuropathy, CHOP chemotherapy, compression therapy, malignant lymphoma","lastPublishedDoi":"10.21203/rs.3.rs-2811473/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2811473/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003ePurpose\u003c/b\u003e\u003c/p\u003e \u003cp\u003eVincristine (VCR) often induces peripheral neuropathy (PN) as an adverse event. Currently, there is no consensus about prevention of vincristine-induced PN (VIPN). In this study, we aimed to investigate the efficacy of compression therapy using surgical gloves for preventing VIPN.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePatients with malignant lymphoma (vincristine-na\u0026iuml;ve) who were receiving chemotherapy with cyclophosphamide, doxorubicin, VCR, and prednisolone, with or without rituximab, every 3 weeks for six cycles were eligible. For every VCR infusion, each patient wore two one-size smaller gloves on one hand (study hand) for 90 min. The other hand was bare (control hand). PN was assessed at each treatment using common terminology criteria for adverse events ver. 4.0.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFifty-one patients with malignant lymphoma were enrolled and 44 were evaluated. The occurrence rates of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 sensory PN were 13.6 and 13.6% in the study and control hands, respectively (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.0) at 1 month after treatment. The occurrence rates of grade\u0026thinsp;\u0026ge;\u0026thinsp;2 motor PN were 15.9 and 15.9% in the study and control hands, respectively (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.0).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eCompression therapy using surgical gloves showed no significant effect for the prevention of VIPN.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTrial registration\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFirst November 2018 National University Hospital Council of Japan (UMIN 000034145).\u003c/p\u003e","manuscriptTitle":"Compression therapy using surgical gloves was ineffective for the prevention of vincristine-induced neuropathy in patients with malignant lymphoma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-04-20 13:44:30","doi":"10.21203/rs.3.rs-2811473/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-08-02T21:41:05+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-07-17T08:44:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"36ff85e7-8605-4b4a-bd24-75bf4e804f58","date":"2023-05-24T22:17:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-05-21T21:08:09+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-05-21T14:05:56+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-04-18T09:04:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"Supportive Care in Cancer","date":"2023-04-13T07:54:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"supportive-care-in-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jscc","sideBox":"Learn more about [Supportive Care in Cancer](https://www.springer.com/journal/520)","snPcode":"520","submissionUrl":"https://submission.nature.com/new-submission/520/3","title":"Supportive Care in Cancer","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"ab8c7fd6-b519-41be-ac86-c6e8948f8c45","owner":[],"postedDate":"April 20th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-02-26T15:05:04+00:00","versionOfRecord":{"articleIdentity":"rs-2811473","link":"https://doi.org/10.1007/s00520-024-08389-3","journal":{"identity":"supportive-care-in-cancer","isVorOnly":false,"title":"Supportive Care in Cancer"},"publishedOn":"2024-02-20 15:01:18","publishedOnDateReadable":"February 20th, 2024"},"versionCreatedAt":"2023-04-20 13:44:30","video":"","vorDoi":"10.1007/s00520-024-08389-3","vorDoiUrl":"https://doi.org/10.1007/s00520-024-08389-3","workflowStages":[]},"version":"v1","identity":"rs-2811473","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2811473","identity":"rs-2811473","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}