National Comprehensive Cancer Networks Campaign for Safe Handling of Vincristine

Vincristine is an important chemotherapeutic agent properly administrated intravenously in the treatment of many patients with leukemia or lymphoma. These same patients often require treatment with other agents that are appropriately and intentionally administered intrathecally. While rare, there are instances in which vincristine prepared in a syringe for IV administration is confused with other agents such as methotrexate or cytarabine prepared in syringes for intrathecal injection, and the vincristine is inadvertently administered intrathecally. Vincristine is a neurotoxin that causes peripheral neuropathy when given intravenously and causes profound neurotoxicity if given into the spinal fluid, which flows around the spinal cord and brain.Vincristine administered intrathecally is uniformly fatal, causing ascending paralysis, other neurological defects, and eventually death over a few days.
To ensure that vincristine is always administered properly, NCCN’s Best Practices Committee, which is dedicated to improving cancer treatment protocols, has issued guidelines advising health care providers to always dilute vincristine in a mini IV-drip bag and never use a syringe. This precaution renders it impossible to accidentally administer the medication into the spine and greatly decreases the chances of improper dosage.




Visit the NCCN website to learn more: https://www.nccn.org/JustBagIt/