levoleucovorin and Paralysis

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.

Topics: Antidotes; Caffeine; Child; Female; Humans; Leucovorin; Medication Errors; Paralysis; Paraplegia; Pyridoxine; Vincristine

A few reports have documented overdoses of vincristine sulfate. The present report describes our experience with serious complications of a vincristine overdose in an 18-year-old female who had methotrexate-resistant invasive mole. The patient received VAC therapy as the second line chemotherapy after 2 courses of MTX therapy. In the 6th course of VAC therapy, she was given 5 consecutive daily doses of VCR by mistake. On the 5th day of this VAC therapy, she showed the following toxic symptoms: abdominal pain, lumbago, insomnia, bleeding tendency, absence of motor reflex, leukopenia, and paralytic ileus. These symptoms led to realization of the VCR overdose. Leucovorin calcium administration and supportive treatment were carried out. Although it was difficult to evaluate the efficacy of leucovorin calcium on the vincristine toxic symptoms, she recovered and was discharged on the 36th hospital day.

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Dactinomycin; Female; Humans; Hydatidiform Mole, Invasive; Leucovorin; Leukopenia; Paralysis; Parenteral Nutrition, Total; Pregnancy; Uterine Neoplasms; Vincristine

Topics: Aphasia; Brain Neoplasms; Carotid Arteries; Cerebral Angiography; Drug Therapy; Glioma; Humans; Infusions, Intra-Arterial; Leucovorin; Methotrexate; Necrosis; Paralysis; Parietal Lobe; Surgical Procedures, Operative; Temporal Lobe