Glutamic Acid in Reducing Nerve Damage Caused by Vincristine in Young Patients With Cancer

INCLUSION CRITERIA:

• Patients ≥ 3 and < 21 years of age at the time of study registration.
• Patients newly diagnosed with Wilm's tumor and scheduled to receive at least 9consecutive weeks of chemotherapy with a vincristine-containing regimen.
• Patients newly diagnosed with rhabdomyosarcoma and scheduled to receive at least 9consecutive weeks of chemotherapy with a vincristine-containing regimen.
• Patients newly diagnosed with ALL and scheduled to receive 4 consecutive weeks ofchemotherapy with a vincristine-containing regimen with accompanying steroid therapy.
• Patients newly diagnosed with Non- Hodgkins Lymphoma (NHL) and scheduled to receive 4consecutive weeks of chemotherapy with a vincristine-containing regimen withaccompanying steroid therapy.
• Patients with no underlying neuromuscular disease or peripheral neuropathy

EXCLUSION CRITERIA:

• Abnormal baseline peripheral neurologic exam (i.e. or peripheral neuropathy)
• Patients with:
• seizure disorders
• primary intracranial malignancy
• family history of Charcot Marie Tooth Disease
• a recent history of GuillianBarré26
• Patients receiving concomitant itraconazole are at risk for increased vincristinetoxicity and therefore are ineligible.
• Patients who are regularly using laxatives or stool softeners for constipation at thetime of enrollment are not eligible to participate in the study. Likewise, sinceprevention of neuro-constipation will be evaluated, patients with an ongoing historyof constipation that has required frequent use of laxatives or stool softeners shouldnot be enrolled.
• Patients should not be scheduled to receive laxatives or stool softenersprophylactically to prevent constipation, as the prevention of neuro-constipation willbe evaluated in this study; however, when patients show signs of developingconstipation while on chemotherapy, as determined by the treating physician, they maybe treated with laxatives or stool softeners at the clinician's discretion. Use oflaxatives or stool softeners will be documented on the concomitant medication log.