Chemo-Induced Peripheral Neuropathy May Persist Years After Lymphoma Care

Among patients with lymphoma who received frontline chemotherapy, instances of chemotherapy-induced peripheral neuropathy (CIPN) were persistent for years following the completion of treatment, according to findings presented in a poster session at the 51st Annual Oncology Nursing Society (ONS) Congress.¹

Regarding 6 post-treatment visits (T4) for 11 eligible patients, data revealed a response rate of 55% to chemotherapy. Additionally, 50% (n = 3) of patients reported persistent numbness and tingling in their feet or toes at the time of T4. The mean age among this group was 68.6 years, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN (CIPN20) scores ranged from 25 to 36, which were consistent with mild to moderate CIPN. Coasting, which investigators described as worsening CIPN following the completion of treatment, was highlighted in 2 patients based on increasing CIPN20 scores.

According to the study authors, persistent CIPN was shown to reduce quality of life (QOL), decrease the frequency of activities of daily living (ADLs) and instrumental ADLs, and heighten the risk of falls. Furthermore, clinician-rated toxicities appeared to consistently underreport the severity of events compared with patient-reported outcomes (PROs).

“Our study provides evidence of persistent moderate CIPN, as measured with validated PROs. Results are consistent with previous reports of older age as a risk factor for CIPN,” lead study author Gretchen A. McNally, PhD, MPH, ANP-BC, AOCNP, a nurse practitioner-scientist at the Arthur G. James Cancer Hospital of The Ohio State University, wrote with coauthors in the poster.^1,2 “[Our study] suggests that CIPN can persist well into survivorship among [patients with] lymphoma, adversely affecting long-term QOL. [It] demonstrates potential coasting phenomenon warranting further examination in future longitudinal studies.”

Regarding the study’s background, the authors noted that CIPN was known to negatively affect disease outcomes and long-term QOL. Additionally, clinical manifestations range from mild paresthesia—feelings of tingling or numbness—to severe deficits that require dose reductions, which may limit therapeutic strategies. The authors wrote that CIPN is a well-known toxicity associated with vincristine (Oncovin), a component of frontline regimens for aggressive non-Hodgkin lymphoma such as CHOP (cyclophosphamide plus doxorubicin, vincristine, and prednisone) and EPOCH (etoposide plus prednisone, vincristine, cyclophosphamide, and doxorubicin).

Noting limited data related to persistent CIPN among survivors of lymphoma, the study authors aimed to assess long-term CIPN based on PROs among those who received CHOP or EPOCH for their disease. The investigators secured institutional review board approval to assess T4 visits and evaluate long-term CIPN outcomes. Relevant PROs were determined via CIPN20 criteria, which included a review of clinical records.

Of the 6 patients who were evaluable at the time of T4, all were female (100%). Additionally, the mean age was 54.3 years (range, 19-74). Most patients were White (n = 4), followed by Black (n = 1) and more than 1 race (n = 1).

Across the evaluable population, an equal proportion of patients received EPOCH (50%) and CHOP (50%) for their chemotherapy. The time since completing treatment ranged from 24 to 42 months, or 2.0 to 3.5 years.

From the time of T1 to T4, the CIPN20 score increased from 20 to 28 in patient 1. Additionally, scores changed from 21 to 36 for patient 2, 21 to 20 for patient 3, 20 to 21 for patient 4, 21 to 25 for patient 5, and 19 to 22 for patient 6.

References

1. McNally GA, Flora L, Krishna S, Shin GJ. Patient-reported outcomes reveal lasting impact of chemotherapy: insights after frontline CHOP or EPOCH in lymphoma survivors. Presented at the 51st Annual Oncology Nursing Society (ONS) Congress; May 13-17, 2026; San Antonio, TX.
2. Bulls HW, Hoogland AI, Kennedy B, et al. A longitudinal examination of associations between age and chemotherapy-induced peripheral neuropathy in patients with gynecologic cancer. Gynecol Oncol. 2019;152(2):310-315. doi:10.1016/j.ygyno.2018.12.002.