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Many drugs used to manage pediatric leukemia have highly toxic side-effects. In the case of vincristine, neurotoxicity (damage to nerve cells and nerve function) is a potentially serious side effect that may limit the dose of the drug. Symptoms of neurotoxicity are motor dysfunction, muscle weakness, muscle pain, and paresthesia (numbness and tingling). Vincristine treatment for acute lymphoblastic leukemia (characterized by immature while blood cells, lymphocytes and lymphoblasts) may cause neurotoxic side-effects on cardiac function by inducing cardioneuropathy (impairment of the nerves that innervate the heart). Researchers studied the heart rate variability (HRV) of nine children being treated with vincristine for acute lymphoblastic leukemia. Evidence strongly suggests that vincristine severely limited vagal nerve conduction (a nerve involved in contractions of the heart). Researchers advocate close monitoring of the autonomic nervous system among children undergoing therapy with vincristine (the autonomic nervous system effects involuntary body functions, such as heart function). The authors conclude that HRV is a suitable means of monitoring autonomic neurotoxicity.