Vincristine Neurotoxicity

Vincristine sulfate, a useful agent in treatment of childhood leukemia, lymphoma, and a great variety of solid tumors, is a potentially serious neurotoxin. A mixed sensory-motor neuropathy is the most common manifestation of drug toxicity, but other effects have been attributed to this drug, including seizures, mental changes, orthostatic hypotension, inappropriate secretion of antidiuretic hormone, and potentiation of preexisting neurological disease. A critical review of published data does not confirm a causal relation between vincristine administration and these neurotoxic effects. Only in the cases of hyponatremia that are secondary to inappropriate secretion of antidiuretic hormone has a convincing causal relation been established.