Background: Vincristine is associated with CIPN that can impair daily function. Methods: Patients 3.0-9.9 years without neurological disorders, enrolled on ALL0932 at 26 sites, were evaluated ~2 weeks post-induction (vincristine x 4 doses, dexamethasone x 28 days, and pegaspargase) by a physical/occupational therapist for peripheral neuropathy, proximal strength and fitness. Parents reported daily physical function with The Pediatric Outcomes Data Collection Instrument (PODCI). Percentages of measured impairments and limited daily function were calculated and analyzed by multivariable logistic regression. Results: The 149 (80% of eligible) subjects were 48% female, 56% white non-Hispanic (26% Hispanic, 18% other) and a mean of 5.1± 1.7 years. The table summarizes the substantial frequency of measured and reported impairments. Impaired peripheral motor function in the upper (OR=4.6; p=0.01) and lower extremities (OR=3.4; p=0.06) and younger age (OR=1.7; p=0.02) were associated with report of limited physical function. Conclusions: Our data suggest that induction therapy causes significant motor neuropathy predictive of daily physical function in young children with SR ALL. AALL0932 will assess how this neuropathy evolves throughout ALL therapy. Clinical trial information: NCT01190930.

* P value from two-sided exact test < 0.001 compared to expected value of 7% for measured impairments and 13.6% for PODCI in healthy norms.