Vincristine

say: vin-KRIS-teen

NOTE: Before I say anything else, you should be aware that vincristine given intrathecally -- into the spinal fluid -- is FATAL! If you are not in the habit of checking your child's drugs before administration, administration by perhaps a tired and over-worked health professional, get into that habit!! At the very least before spinal administrations of chemotherapy.

The CA name of this compound is 22-oxovincaleukoblastine or leurocristine. Is is also known as any of the following: Oncovin, Vincasar, Vincrex, Leurocristine, VCR, LCR, Kyocristine, PES, Vincosid, Vincasar PES.

Vincristine is an alkaloid isolated from the Madagascar periwinkle, Catharantus roseus, formerly classified as Vinca rosea, which led to it being called a Vinca alkaloid, and thus vincristine.

In pure form, it is a solid that melts at 218-220 degrees centigrade. It is an antineoplastic.

Plant alkaloids like vincristine prevent cell division, or mitosis. There are several phases of mitosis, one of which is the metaphase. During metaphase, the cell pulls duplicated DNA chromosomes to either side of the parent cell in structures called "spindles". These spindles ensure that each new cell gets a full set of DNA. Spindles are microtubular fibers formed with the help of the protein "tubulin". Vincristine binds to tubulin, thus preventing the formation of spindles and cell division.

Vincristine is given by injection. The side effects that usually do not require medical attention are:

• bloating
• diarrhea
• loss of weight
• nausea and vomiting
• skin rash
• often causes a temporary loss of hair

It has a whole slew of other side effects, including neurological symptoms (see below). It can cause redness, pain, or swelling at the place of injection. Any of these symptoms should be reported soon to the oncodoc, especially redness at the injection site. From personal experience, my son had a numbness in his fingers and no reflexes when his knee was tapped. His oncodoc attributes this to the vincristine. Other parents attribute neurological problems and especially constipation and stomach cramps to vincristine; also "foot drop", a characteristic manner of walking.

Vincristine Induced Laryngeal Paralysis - VLP (hoarse voice) The natural history of vincristine-induced laryngeal paralysis in children. Kuruvilla G et al., Arch Otolaryngol Head Neck Surg. 2009 Jan;135(1):101-5. Journal article abstract.

From another online database: "may also cause leukopenia, anemia, thrombocytopenia, neuritic pain, constipation, difficulty in walking, sensory loss, paresthesia, slapping gait, loss of deep-tendon reflexes, muscle wasting, paralytic ileus in young children, convulsions, hypertension, abdominal cramps, ataxia, foot drop, weight loss, hypotension, rash, optic atrophy with blindness, transient headache, nausea, vomiting, anorexia, diarrhea, intestinal necrosis, bladder atony, cranial nerve manifestations, jaw pain, pharyngeal pain, parotid gland pain, bone pain, back pain, limb pain, myalgias." These are generally reversible.

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