Potential salvage therapy for inadvertent intrathecal administration of vincristine.
Vincristine is an anti-neoplastic agent for intravenous use. Inadvertent intrathecal administration of vincristine tends to follow a predictable clinical sequence of a progressive ascending radiculomyeloencephalopathy, usually fatal in outcome. We report a case of a 10-year-old girl who suffered an inadvertent intrathecal vincristine administration. We have outlined the management strategy used and her consequent neurological progress. She has survived but with a significant neurological deficit. Her outcome is, however, less severe than in previous literature reports; this may in part be attributable to early aggressive neurological management. This case also serves to highlight the tragic consequences of human error when handling chemotherapeutic agents of this nature.
Michelagnoli
M P
MP
Department of Paediatric Oncology, St James University Hospital, Leeds.
Bailey
C C
CC
Wilson
I
I
Livingston
J
J
Kinsey
S E
SE
D000931:Antidotes; D002110:Caffeine / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use*; D008508:Medication Errors; D010243:Paralysis / Q000139:chemically induced* / Q000188:drug therapy / Q000601:surgery; D010264:Paraplegia / Q000139:chemically induced / Q000188:drug therapy / Q000601:surgery; D011736:Pyridoxine / Q000627:therapeutic use*; D014750:Vincristine / Q000009:adverse effects*
D000931:Antidotes; D002110:Caffeine; D014750:Vincristine; D011736:Pyridoxine; D002955:Leucovorin