Vincristine Sulfate (DBL)

What it is used for

Vincristine sulfate is indicated in acute leukaemia – current practices of cancer chemotherapy involve the simultaneous use of several agents. For enhanced therapeutic effect without additive toxicity, agents with different dose-limiting clinical toxicities and different mechanisms of action are generally selected. It is rarely possible to achieve equally good results with single agent treatment. Thus vincristine sulfate is often chosen as part of polychemotherapy because of its unique clinical toxicity (neuropathy). See DOSAGE AND ADMINISTRATION for possible increased toxicity when used in combination therapy. It has been shown to be useful in combination with other oncolytic agents in Hodgkin’s disease, non-Hodgkin’s malignant lymphomas (lymphocytic, mixed-cell, histiocytic, undifferentiated, nodular and diffuse types), rhabdomyosarcoma, neuroblastoma, Wilm’s tumour, osteogenic sarcoma, mycosis fungoides, Ewing’s sarcoma, carcinoma of the uterine cervix, breast cancer, malignant melanoma, oat-cell carcinoma of the lung, and gynaecological tumours of childhood, In recent years, multiple-agent regimens have been developed for the treatment of a variety of malignant disorders in children. Paediatric patients with neuroblastoma, osteogenic sarcoma, Ewing’s sarcoma, rhabdomyosarcoma, Wilm’s tumour, Hodgkin’s disease, non-Hodgkin’s lymphomas, embryonal carcinoma of the ovaries, and rhabdomyosarcoma of the uterus should be considered candidates for such polychemotherapy treatment. Close co-operation among oncologists, paediatricians, radiologists and surgeons is required to achieve the best possible results. Patients with true idiopathic thrombocytopenic purpura refractory to splenectomy and short-term treatment with adrenocortical steroids may respond to vincristine sulfate, but the drug is not recommended as primary treatment for this disorder. Recommended weekly doses of vincristine sulfate given for 3 to 4 weeks have produced permanent remissions in some patients. If patients fail to respond after 3 to 6 doses, it is unlikely that there will be any results with additional doses.