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January 21, 1974

Vincristine Neuropathy

Author Affiliations

Englewood, NJ

JAMA. 1974;227(3):325. doi:10.1001/jama.1974.03230160053020

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To the Editor.—  A caveat about the use of vincristine sulfate intravenously is warranted when the patient has a fresh surgical lesion. A significant portion of the injected vincristine may find its way into the incisional site as a result of capillary oozing, and may create an indurated, inflammatory, local, necrotic reaction. The lesion is quite similar to that caused by inadvertent subcutaneous leakage resulting from faulty intravenous injection.Two recent experiences are cited. In the first, an excisional biopsy was performed because of a fibrolipoma of the chest wall in a patient with Hodgkin disease. One day later, 2 mg vincristine sulfate were administered intravenously. Within 72 hours, a typical vincristine "slough" was present at the incisional site. The lesion healed in two weeks.A second example arose in a 14-year-old boy with acute lymphoblastic leukemia. A deep abscess in the calf muscles was treated with adequate incision and