BACKGROUND Catastrophic errors in healthcare are rare, yet the consequences are so serious that where possible, special procedures are put in place to prevent them. As systems become safer, it becomes progressively more difficult to detect the remaining vulnerabilities. Using inadvertent intrathecal administration of vinca alkaloids as an example, we investigated whether analysis of incident re...

Leukemia affects the central and peripheral nervous system. Neurologic complications are a consequence of direct leukemic infiltration, as occurs with leukemic meningitis, and due to complications of either antileukemic treatment (thrombocytopenic or disseminated intravascular coagulation-related intracranial hemorrhage, steroid myopathy, vinca alkaloid peripheral neuropathy) or immune compromi...

Three patients receiving vincristine or binblastine developed recurrent laryngeal nerve paralysis, which resolved when the drug was withdrawn. The presence of mediastinal lymphadenopathy in patients with lymphoma may obscure the correct diagnosis, with the danger that the condition will produce respiratory distress if vinca alkaloid treatment is continued.

The ability of a class of C-20' modified vinca alkaloid congeners to induce tubulin spiral formation was investigated relative to their ability to inhibit microtubule assembly, their cytotoxicity against a leukemic cell line, L1210, and their measured and calculated partition coefficients. These studies were prompted by the observation that the energetics of vinca alkaloid-induced tubulin spira...

PURPOSE When evaluated in patients with ovarian and other cancer, vintafolide (EC145), a potent folate-targeted vinca alkaloid conjugate, displayed a toxicity profile that seemed to be nonoverlapping with many standard-of-care cancer therapeutics. It was, therefore, hypothesized that combining vintafolide with certain approved anticancer drugs may afford greater therapeutic efficacy compared wi...

The neurotoxicity of the vincristine is well known, however, cranial neuropathy is not widely recognized. We describe a child with acute lymphoblastic leukemia who developed vincristine-induced bilateral vocal cord paralysis. Vocal cord paralysis resolved spontaneously upon withdrawal of the vincristine. Vinca-alkaloid-induced vocal cord paralysis is a potentially dangerous but reversible condi...

The syntheses of 20,20-difluorocatharanthine and congeners, starting from the naturally occurring catharanthine, are reported. The fluorinated catharanthine analogues were investigated as potential precursors to dimeric Vinca alkaloids of the vinflunine family. However, the biomimetic coupling of the fluorinated catharanthine derivatives with vindoline led to unexpected alkaloid structures, the...