ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد ایتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Vincristine (conventional): Drug information

Vincristine (conventional): Drug information
(For additional information see "Vincristine (conventional): Patient drug information" and see "Vincristine (conventional): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
ALERT: US Boxed Warning
Experienced provider:

Vincristine should be administered by individuals experienced in the administration of vincristine.

Extravasation:

It is extremely important that the IV needle or catheter be properly positioned before any vincristine is injected. Leakage into surrounding tissue during IV administration may cause considerable irritation. If extravasation occurs, discontinue the injection immediately and then introduce any remaining portion of the dose into another vein. Local injection of hyaluronidase and the application of moderate heat to the area of leakage will help disperse the drug and are thought to minimize discomfort and the possibility of cellulitis.

For IV use only:

For IV use only. Fatal if given by other routes. See "Additional Information/Pharmacotherapy Pearls" for treatment of patients given (inadvertent) intrathecal administration of vincristine.

Brand Names: US
  • Vincasar PFS
Pharmacologic Category
  • Antineoplastic Agent, Antimicrotubular;
  • Antineoplastic Agent, Vinca Alkaloid
Dosing: Adult

Note: Dispense vincristine in a minibag or other flexible plastic container (NOT in a syringe) (ISMP 2020). Some doses may be capped at a maximum of 2 mg/dose; refer to protocol. Dosing and frequency may vary by protocol and/or treatment phase. Patients receiving vincristine should be on a prophylactic bowel management regimen to prevent constipation.

Acute lymphocytic leukemia:

CALGB 10403 regimen: Patients <40 years of age: IV: Induction phase: 1.5 mg/m2 (maximum: 2 mg) on days 1, 8, 15, and 22; Extended remission induction phase (if required): 1.5 mg/m2 (maximum: 2 mg) on day 1 and 8; Remission consolidation phase: 1.5 mg/m2 (maximum: 2 mg) on days 15, 22, 43, and 50; Delayed intensification phase: 1.5 mg/m2 (maximum: 2 mg) on days 1, 8, 43, and 50; Maintenance phase: 1.5 mg/m2 (maximum: 2 mg) on days 1, 29, and 57 of a 12-week cycle; continue maintenance phase until 2 years (females) or 3 years (males) from start of interim maintenance; phases are part of combination chemotherapy; refer to protocol for details (Stock 2019).

DFCI Consortium regimen: Patients ≤50 years of age: IV: Induction phase: 2 mg on days 1, 8, 15, and 22 (4-week treatment cycle); CNS therapy phase: 2 mg for one dose (3-week treatment cycle); Intensification phase: 2 mg on day 1 (3-week cycle; continue for 30 weeks); Continuation phase: 2 mg on day 1 (3-week cycle; continue for 74 weeks); phases are part of combination chemotherapy; refer to protocol for details (DeAngelo 2015).

Hyper-CVAD regimen: IV: 2 mg on days 4 and 11 during odd-numbered cycles (cycles 1, 3, 5, 7 [in combination with cyclophosphamide, mesna, doxorubicin, and dexamethasone]) of an 8-cycle phase, followed by maintenance treatment (if needed) of 2 mg once monthly for 2 years (Kantarjian 2004), plus a tyrosine kinase inhibitor (for Philadelphia chromosome-positive disease) (Ravandi 2010; Thomas 2004).

CALBG 8811 regimen: IV: Induction phase: 2 mg on days 1, 8, 15, and 22 (4-week treatment cycle); Early intensification phase: 2 mg on days 15 and 22 (4-week treatment cycle, repeat once); Late intensification phase: 2 mg on days 1, 8, and 15 (8-week treatment cycle); Maintenance phase: 2 mg on day 1 every 4 weeks until 24 months from diagnosis; phases are part of combination chemotherapy; refer to protocol for details (Larson 1995).

GRAALL 2003 regimen: Patients <60 years of age: IV: Induction phase: 2 mg on days 1, 8, 15, and 22; Consolidation phase: 2 mg on day 15 of consolidation blocks 2, 5, and 8; Late intensification phase: 2 mg on days 1, 8, and 15; Maintenance phase: 2 mg on day 1 every month for 12 months; phases are part of combination chemotherapy; refer to protocol for further information (Huguet 2009).

GRAALL 2005 regimen: Patients <60 years of age: IV: Induction phase: 2 mg on days 1, 8, 15, and 22; Interphase-1: 2 mg on day 1; First, second, and third consolidation phases (block 2, block 5, and block 8, respectively): 2 mg on day 15; Late intensification phase (if complete response after first course): 2 mg on days 1, 8, 15, and 22; Maintenance phase: 2 mg on day 1 monthly for 12 months; phases are part of combination chemotherapy; refer to protocol for further information (Huguet 2018).

MRC UKALL XII/ECOG E2993: Patients <60 years of age: IV: Induction (phase 1): 1.4 mg/m2 on days 1, 8, 15, and 22; Consolidation phase (cycle 1): 1.4 mg/m2 on days 1, 8, 15, and 22; Maintenance phase: 1.4 mg/m2 once every 3 months; continue maintenance for 2.5 years from the start of intensification; phases are part of combination chemotherapy; refer to protocol for further information (Rowe 2005).

Philadelphia chromosome-positive acute lymphoblastic lymphoma:

Kim 2015: IV: 2 mg on days 1 and 8 of induction and consolidation A cycles (in combination with daunorubicin, prednisolone, cytarabine, etoposide, methotrexate, leucovorin, and nilotinib); refer to protocol for further information.

Rousselot 2016:

Patients ≥55 to ≤70 years of age: Induction: IV: 2 mg once weekly for 4 weeks (in combination with dexamethasone and dasatinib); refer to protocol for further information.

Patients >70 years of age: Induction: IV: 1 mg once weekly for 4 weeks (in combination with dexamethasone and dasatinib); refer to protocol for further information.

Central nervous system tumors (off-label use):

Anaplastic oligodendroglioma/astrocytomas, low-grade gliomas: PCV regimen (in combination with procarbazine, lomustine, and radiation therapy): IV: 1.4 mg/m2 (some protocols cap the vincristine dose at 2 mg; refer to protocols for details) on days 8 and 29 of a 6- to 8-week treatment cycle for 4 to 6 cycles (Buckner 2016; Cairncross 2006; Cairncross 2013; Shaw 2012; van den Bent 2006; van den Bent 2013).

Glioblastoma, recurrent: PCV regimen (in combination with procarbazine and lomustine): IV: 1.4 mg/m2 (maximum: 2 mg) on days 8 and 29 of a 6-week cycle for 7 cycles (Levin 2000) or 1.5 mg/m2 (maximum: 2 mg) on day 1 of a 6-week cycle for up to 6 cycles (Brada 2010).

Medulloblastoma: Adults ≤21 years of age: IV: 1.5 mg/m2 (maximum dose: 2 mg) weekly for a maximum of 8 doses (in combination with radiation, cisplatin, and either lomustine or cyclophosphamide) (Packer 2006).

Chronic lymphocytic leukemia/small lymphocytic leukemia, with Richter transformation (off-label use): IV: 2 mg (flat dose) days 4 and 11 of courses 1, 3, 5, and 7 (in combination with cyclophosphamide, mesna, doxorubicin, and dexamethasone [± rituximab]) and alternates with even courses 2, 4, 6, and 8 (methotrexate, leucovorin, and cytarabine) (Thomas 2006; Tsimberidou 2003) or 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle (in combination with cyclophosphamide, doxorubicin, and prednisone [± rituximab]) (Coiffier 2002; Tsimberidou 2006).

Ewing sarcoma (off-label use): VDC/IE regimen: VDC: IV: 2 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle (in combination with doxorubicin and cyclophosphamide), alternates with IE (ifosfamide and etoposide) for a total of 17 cycles (Grier 2003).

Gestational trophoblastic tumors, high-risk (off-label use): EMA/CO regimen: IV: 1 mg/m2 on day 8 of a 2-week treatment cycle (in combination with etoposide, methotrexate, leucovorin, dactinomycin, and cyclophosphamide), continue for at least 2 treatment cycles after a normal hCG level (Escobar 2003; Lurain 2006).

Hodgkin lymphoma:

BEACOPP (standard or escalated) regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 8 of a 21-day treatment cycle (in combination with bleomycin, etoposide, doxorubicin, cyclophosphamide, procarbazine, and prednisone) for 8 cycles (Diehl 2003).

Stanford-V regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) in weeks 2, 4, 6, 8, 10, and 12 (in combination with mechlorethamine, vinblastine, bleomycin, doxorubicin, etoposide, and prednisone) (Horning 2000; Horning 2002).

Merkel cell carcinoma, advanced or recurrent (off-label use; based on limited data): CAV regimen: IV: 2 mg on day 1 every 21 days (in combination with cyclophosphamide and doxorubicin) (Fenig 1997).

Multiple myeloma (off-label use):

DVD regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 28-day treatment cycle (in combination with pegylated doxorubicin and dexamethasone) (Rifkin 2006).

VAD regimen: IV: 0.4 mg/day continuous infusion for 4 days (over 96 hours) (total 1.6 mg/cycle) of a 28-day treatment cycle (in combination with conventional doxorubicin and dexamethasone) (Rifkin 2006).

Non-Hodgkin lymphoma:

Burkitt lymphoma:

CALGB 10002 regimen (cycles 2 through 7): IV: 2 mg on day 1 every 3 weeks (in combination with cyclophosphamide, prednisone, ifosfamide, dexamethasone, methotrexate, leucovorin, cytarabine, etoposide, rituximab, doxorubicin, intrathecal therapy, and filgrastim); refer to protocol for details (Rizzieri 2014).

CODOX-M/IVAC: Cycles 1 and 3 (CODOX-M): IV: 1.5 mg/m2 (no maximum dose) days 1 and 8 of cycle 1 and days 1, 8, and 15 of cycle 3 (Magrath 1996) or 1.5 mg/m2 (maximum dose: 2 mg) days 1 and 8 of cycles 1 and 3 (Mead 2002; Mead 2008); CODOX-M is in combination with cyclophosphamide, doxorubicin, methotrexate, and CNS prophylaxis and alternates with IVAC (etoposide, ifosfamide, mesna, cytarabine, and CNS prophylaxis) for a total of 4 cycles.

R-Hyper-CVAD: IV: 2 mg (flat dose) days 4 and 11 of courses 1, 3, 5, and 7 (in combination with rituximab, cyclophosphamide, doxorubicin, and dexamethasone) and alternates with even courses 2, 4, 6, and 8 (rituximab, methotrexate and cytarabine) (Thomas 2006).

Diffuse large B-cell lymphoma:

CHOP/R-CHOP regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle for 8 cycles (in combination with cyclophosphamide, doxorubicin, and prednisone [± rituximab]) (Coiffier 2002).

Dose-adjusted EPOCH/EPOCH-R regimen: IV: 0.4 mg/m2/day continuous infusion for 4 days (over 96 hours) (total 1.6 mg/m2/cycle; dose not usually capped) of a 21-day treatment cycle (in combination with etoposide, prednisone, cyclophosphamide, and doxorubicin, ± rituximab) (García-Suárez 2007; Wilson 2002).

R-CEOP regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle for 3 to 6 cycles (in combination with rituximab, cyclophosphamide, etoposide, and prednisone) (Moccia 2009).

Follicular lymphoma:

CVP regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle (in combination with cyclophosphamide and prednisone [± rituximab or obinutuzumab]) for 8 cycles (Marcus 2005; Marcus 2017).

R-CHOP regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle for 6 to 8 cycles (in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone) (Hiddemann 2005).

Peripheral T-cell lymphoma:

CHOEP regimen: IV: 2 mg on day 1 of a 21-day treatment cycle (in combination with cyclophosphamide, doxorubicin, etoposide, and prednisone) for 6 to 8 cycles (Pfreundschuh 2004; Schmitz 2010).

CHOP regimen: IV: 1.4 mg/m2 (maximum dose: 2 mg) on day 1 of a 21-day treatment cycle (in combination with cyclophosphamide, doxorubicin, and prednisone) (Schmitz 2010).

Primary mediastinal B-cell lymphoma: DA-EPOCH-R regimen: IV: 0.4 mg/m2/day (no cap) as a continuous infusion on days 1 to 4 (over 96 hours) dose-adjusted for subsequent cycles based on neutrophil and platelet counts during nadir (in combination with etoposide, prednisone, cyclophosphamide, doxorubicin, rituximab, and filgrastim); repeat cycle every 3 weeks for a total of 6 to 8 cycles (Dunleavy 2013)

Ovarian cancer (off-label use): VAC regimen: IV: 1.5 mg/m2 (maximum dose: 2 mg) once weekly for 8 to 12 weeks (in combination with dactinomycin and cyclophosphamide) (Slayton 1985)

Pheochromocytoma, malignant (off-label use; based on limited data): IV: 1.4 mg/m2 on day 1 every 3 or 4 weeks (in combination with cyclophosphamide and dacarbazine) (Huang 2008)

Primary CNS lymphoma (off-label use): R-MPV regimen: Induction: IV: 1.4 mg/m2 (maximum dose: 2.8 mg or per standard of practice) on day 1 or day 2 of a 14-day cycle for 5 to 7 cycles (in combination with rituximab, high-dose methotrexate, leucovorin, and procarbazine), followed by reduced-dose whole brain radiotherapy and cytarabine (Morris 2013; Shah 2007) or autologous stem cell transplant (Omuro 2015). Two additional cycles of R-MPV may be administered to patients with partial response after initial induction chemotherapy; refer to protocols for details.

Rhabdomyosarcoma:

VAC regimen: Patients <50 years: IV: 1.5 mg/m2 (maximum dose: 2 mg) once weekly per protocol; duration of therapy depends on risk status (in combination with dactinomycin, cyclophosphamide, and mesna) (Raney 2011)

VA regimen: Patients <50 years: IV: 1.5 mg/m2 (maximum dose: 2 mg) once weekly per protocol (Raney 2011)

Small cell lung cancer, recurrent (off-label use): CAV regimen: IV: 2 mg/dose on day 1 of a 21-day treatment cycle (in combination with cyclophosphamide and doxorubicin) (von Pawel 1999)

Thymoma, advanced (off-label use; based on limited data): ADOC regimen: IV: 0.6 mg/m2 on day 3 every 3 weeks (in combination with cisplatin, doxorubicin, and cyclophosphamide) (Fornasiero 1991)

Manufacturer's labeling: Dosing in the prescribing information may not reflect current clinical practice. IV: 1.4 mg/m2/dose; frequency may vary based on indication and/or protocol.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

No dosage adjustment necessary (Kintzel 1995; Krens 2019).

Hemodialysis: No dosage adjustment is expected (Krens 2019).

Dosing: Hepatic Impairment: Adult

The manufacturer’s labeling recommends the following adjustment: Serum bilirubin >3 mg/dL: Administer 50% of normal dose.

The following adjustments have also been recommended:

Floyd 2006: Serum bilirubin 1.5 to 3 mg/dL or transaminases 2 to 3 times ULN or alkaline phosphatase increased: Administer 50% of dose.

Superfin 2007:

Serum bilirubin 1.5 to 3 mg/dL: Administer 50% of dose.

Serum bilirubin >3 mg/dL: Avoid use.

Dosing: Pediatric

(For additional information see "Vincristine (conventional): Pediatric drug information")

Note: Doses are almost always capped at a maximum of 2 mg/dose/week (Kushner 2010). Dosing and frequency may vary by protocol and/or treatment phase; refer to specific protocol. In pediatric patients, dosing may be based on either BSA (mg/m2) or weight (mg/kg); use extra precaution to verify dosing parameters during calculations. For infants and children <10 kg, dosing is typically reduced (eg, 30% reduction); refer to specific protocols (Rubie 2011). The World Health Organization (WHO) and the Institute for Safe Medication Practices (ISMP) strongly recommend dispensing vincristine in a minibag (NOT in a syringe) (ISMP 2020).

Acute lymphocytic leukemia (ALL) of infancy: Limited data available: Infants <1 year of age at diagnosis: IV: 1.5 mg/m2/dose; maximum dose: 2 mg/dose; reported frequency variable but not more frequently than weekly

Pieters 2007: Interfant-99 protocol: Administer on the following days: Induction phase: Days 8, 15, 22, and 29 (in combination with prednisone, dexamethasone, cytarabine, daunorubicin, l-asparaginase, and CNS intrathecal prophylaxis); Reinduction: Days 1, 8, 15, and 22 (in combination with dexamethasone, 6-thioguanine, daunorubicin, cytarabine, cyclophosphamide, and CNS intrathecal prophylaxis)

Acute lymphocytic leukemia (ALL), standard risk and high risk: Limited data available: Children and Adolescents: IV: 1.5 mg/m2/dose; maximum dose: 2 mg/dose; reported frequency variable but not more frequent than weekly:

Standard risk:

Avramis 2002: Administer dose on the following days: Induction phase: Days 0, 7, 14, and 21; Consolidation phase: Days 0, 28, and 56; Interim maintenance phases: Days 0 and 28; Delayed intensification phase: Days 0, 7, and 14; Maintenance phase: Every 4 weeks

Bostrom 2003: Administer dose on the following days: Induction phase: Days 0, 7, 14, and 21; Consolidation phase: Days 0, 28, and 56; Delayed intensification phase: Days 0, 7, and 14; Maintenance phase: Days 0, 28, and 56

High risk: Larsen 2016: Administer on the following days: Induction phase: Days 1, 8, 15, and 22; Extended Induction: Days 1 and 8; Consolidation: Days 15, 22, 43, and 50; Interim Maintenance 1: Days 1, 15, 29, and 42; Interim Maintenance 2: Days 1, 11, 21, 31, and 41; Delayed Intensification 1: Days 1, 8, 15, 43, and 50; Delayed Intensification 2: Days 1, 8, 15, 43, and 50; Maintenance phase: Every 4 weeks

Ewing sarcoma: Limited data available: Children and Adolescents: Dose and frequency regimens variable:

Grier 2003: IV: 2 mg/m2/dose on day 1 of a 21-day cycle, administer either every cycle or during odd-numbered cycles (VDC/IE regimen); maximum dose: 2 mg/dose

Kolb 2003: IV: 0.67 mg/m2/day as a continuous IV infusion on days 1, 2, and 3; total dose for cycle: 2 mg/m2/cycle (maximum dose/cycle: 2 mg/dose/cycle) during cycles 1, 2, 3, and 6

Hepatoblastoma: Limited data available: Infants, Children, and Adolescents: C5V Regimen: IV: 1.5 mg/m2/dose on Day 2 of a 3-week treatment cycle for 4 cycles (in combination with 5-fluorouracil and cisplatin (Ortega 2000)

Hodgkin lymphoma: Limited data available: Children and Adolescents:

AV-PC (low-risk regimen): IV: 1.4 mg/m2/dose (maximum dose: 2.8 mg/dose) on Day 1 and 8 of a 21-day treatment cycle for 3 cycles (in combination with doxorubicin, prednisone, and cyclophosphamide) (Appel 2016)

ABVE-PC (high-risk and intermediate regimens): IV: 1.4 mg/m2/dose (maximum dose: 2.8 mg/dose) on Day 1 and 8 of a 21-day treatment cycle for 3 to 5 cycles (in combination with doxorubicin, bleomycin, etoposide, cyclophosphamide, and prednisone) (Friedman 2014; Schwartz 2009)

BEACOPP regimen (high-risk regimen): IV: 2 mg/m2/dose on day 7 of a 21-day treatment cycle for 4 cycles (in combination with bleomycin, etoposide, doxorubicin, cyclophosphamide, procarbazine, and prednisone); maximum dose: 2 mg/dose (Kelly 2002)

Low-grade glioma, CNS tumor (low-grade ependymoma, infantile desmoplastic astrocytoma, etc): Limited data available: Children <10 years: IV: 1.5 mg/m2/dose; maximum dose: 2 mg/dose; reported combination chemotherapy and frequency variable but not more frequent than weekly:

Ater 2012: CV regimen: Administer on the following days: Induction phase: Days 0, 7, 14, 21, 28, 35, 42, 49, 56, and 63 of an 84-day cycle (in combination with carboplatin); Maintenance phase: Day 0, 7, and 14 of a 42-day cycle for 8 cycles (in combination with carboplatin)

Ater 2012: TPCV regimen: Administer on days 14 and 28 of a 42-day cycle (in combination with thioguanine, procarbazine, and lomustine) for a total of 8 cycles

Medulloblastoma: Limited data available:

Average-risk regimen: Children ≥3 years and Adolescents: IV: 1.5 mg/m2/dose (maximum dose: 2 mg/dose) once weekly during radiation therapy for up to 8 doses followed by 1.5 mg/m2/dose (maximum dose: 2 mg/dose) on days 1, 7, and 14 per cycle (in combination with cisplatin and either lomustine or cyclophosphamide) for 8 cycles (Packer 2006)

High risk: Head Start II Protocol: Children <10 years: IV: 0.05 mg/kg/dose on Days 1, 8, and 15 of a 21-day cycle in cycles 1 to 3 only (9 total doses in combination with cisplatin, etoposide, cyclophosphamide, methotrexate) (Chi 2004)

Neuroblastoma: Limited data available:

Infants:

Low-dose cyclophosphamide-vincristine regimen: IV: 0.05 mg/kg/dose vincristine on day 1, and repeat in 14 days (Rubie 2003)

CAdO regimen: IV: 0.05 mg/kg/dose on day 1 and 5 and repeated in 21 days (in combination with cyclophosphamide and doxorubicin) (Rubie 2003; Rubie 2011)

Children and Adolescents:

High risk: Induction therapy: IV: 1.5 mg/m2/dose Day 1 in combination with doxorubicin and cyclophosphamide for cycles 2 and 5 (Seif 2013)

Refractory: HD-CTV regimen: IV: 0.067 mg/kg/dose or 2 mg/m2/dose, whichever is lower; maximum dose: 2 mg/dose on day 1 (Kushner 2010)

Non-Hodgkin Lymphomas:

Burkitt lymphoma, Diffuse large B-cell lymphoma and B-cell ALL: Limited data available:

Cairo 2007, Goldman 2013, Goldman 2014: Children and Adolescents:

Reduction (COP regimen): IV: 1 mg/m2/dose; maximum dose: 2 mg/dose on Day 1 (in combination with cyclophosphamide, prednisone, and intrathecal methotrexate)

Induction 1 and 2 (COPADM regimen): IV: 2 mg/m2/dose; maximum dose: 2 mg/dose on Day 1 (in combination with cyclophosphamide, prednisone, doxorubicin, methotrexate, and intrathecal methotrexate)

Maintenance 1 (COPAM regimen) and 3 (COPA regimen): IV: 2 mg/m2/dose; maximum dose: 2 mg/dose on Day 1 (in combination with cyclophosphamide, prednisone, doxorubicin, and methotrexate [maintenance 1 only])

Reiter 1999: Children and Adolescents: IV: 1.5 mg/m2/dose; maximum dose: 2 mg/dose; administer dose on day 1 of cycle AA (in combination with dexamethasone, ifosfamide, methotrexate, cytarabine, etoposide, and CNS prophylaxis) and on day 1 of cycle BB (in combination with dexamethasone, cyclophosphamide, methotrexate, doxorubicin, and CNS prophylaxis)

Primary mediastinal B-cell Lymphoma (PMBCL): Limited data available:

DA-EPOCH-R regimen: Children ≥9 years and Adolescents: IV: 0.4 mg/m2/day as a continuous infusion over 96 hours on days 1 to 4 (in combination with rituximab, doxorubicin, etoposide, cyclophosphamide, prednisone, and filgrastim); no maximum dose. Doses for subsequent cycles are based on neutrophil and platelet counts; repeat cycle every 3 weeks for a total of 6 to 8 cycles (Dunleavy 2013; Giulino-Roth 2017; Woessmann 2013)

Retinoblastoma: Limited data available:

Infants and Children ≤36 months: IV: 0.05 mg/kg/dose (maximum dose: 2 mg/dose); reported frequency variable but not more frequent than weekly

Rodriguez-Galindo 2003: Administer dose on day 1 every 21 days in combination with carboplatin for 8 cycles

Friedman 2000: Administer dose day 0 every 28 days in combination with carboplatin and etoposide for 6 cycles

Children >36 months: IV: 1.5 mg/m2 (maximum dose: 2 mg/dose) on day 0 every 28 days in combination with carboplatin and etoposide for 6 cycles (Friedman 2000)

Rhabdomyosarcoma: Limited data available (Raney 2011; Walterhouse 2011; Walterhouse 2014); reported frequency variable but not more frequent than weekly: Duration of therapy depends on risk status; VA (in combination with dactinomycin) or VAC regimen (in combination with dactinomycin and cyclophosphamide):

Infants: IV: 0.025 mg/kg/dose

Children 1 to <3 years: IV: 0.05 mg/kg/dose

Children ≥3 years and Adolescents: IV: 1.5 mg/m2/dose (maximum dose: 2 mg/dose)

Wilms tumor: Limited data available (Green 2007):

Infants and Children weighing ≤30 kg: IV: 0.05 mg/kg/dose (maximum dose: 2 mg/dose) weeks 1, 2, 4, 5, 6, 7, 8, 10, and 11, followed by 0.067 mg/kg/dose (maximum dose: 2 mg/dose) weeks 12, 13, 18, and 24 (in combination with doxorubicin, cyclophosphamide, mesna, etoposide, and filgrastim)

Children and Adolescents weighing >30 kg: IV: 1.5 mg/m2/dose (maximum dose: 2 mg) weeks 1, 2, 4, 5, 6, 7, 8, 10, and 11, followed by 2 mg/m2/dose (maximum dose: 2 mg) weeks 12, 13, 18, and 24 (in combination with doxorubicin, cyclophosphamide, mesna, etoposide, and filgrastim)

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no pediatric specific recommendations; consult individual protocols; based on experience in adult patients, dosing adjustment may not be necessary.

Dosing: Hepatic Impairment: Pediatric

All patients: The manufacturer's labeling recommends the following adjustment: Serum bilirubin >3 mg/dL: Administer 50% of normal dose.

The following adjustments have also been recommended:

Floyd 2006: Serum bilirubin 1.5 to 3 mg/dL or transaminases 2 to 3 times ULN or alkaline phosphatase increased: Administer 50% of dose.

Superfin 2007:

Serum bilirubin 1.5 to 3 mg/dL: Administer 50% of dose.

Serum bilirubin >3 mg/dL: Avoid use.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Obesity: Adult

ASCO guidelines for appropriate chemotherapy dosing in adults with cancer with a BMI ≥30 kg/m2: The practice of limiting vincristine doses to 2 mg is not supported by current clinical data. Utilize patient's actual body weight (full weight) for calculation of BSA- or weight-based dosing, particularly when the intent of therapy is curative; manage regimen-related toxicities in the same manner as for patients with a BMI <30 kg/m2; if a dose reduction is utilized due to toxicity, may consider resumption of full weight-based dosing with subsequent cycles, if cause of toxicity (eg, hepatic or renal impairment) is clearly established and fully resolved (ASCO [Griggs 2021]).

Dosing: Adjustment for Toxicity: Adult

Constipation (including upper colon impaction): May require high enemas and laxatives.

Progressive dyspnea with pulmonary dysfunction: Permanently discontinue vincristine.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous, as sulfate [preservative free]:

Vincasar PFS: 1 mg/mL (1 mL, 2 mL)

Generic: 1 mg/mL (1 mL, 2 mL)

Generic Equivalent Available: US

Yes

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous, as sulfate:

Generic: 1 mg/mL (1 mL, 2 mL, 5 mL)

Administration: Adult

For IV administration only. Fatal if given by other routes.

Dispense vincristine in a minibag or other flexible plastic container (NOT in a syringe) (ISMP 2020). Vincristine should NOT be delivered to the patient at the same time with any medications intended for CNS administration.

IV: Preferred administration is as a short 5- to 10-minute infusion in a 25 to 50 mL minibag. Some protocols utilize a 24-hour continuous infusion (off-label rate). The minibag may be infused directly into an IV catheter or into a running IV infusion line.

Vesicant; ensure proper needle or catheter placement prior to and during infusion. Avoid extravasation.

Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do NOT flush the line); initiate hyaluronidase antidote; remove needle/cannula; apply dry warm compresses for 20 minutes 4 times a day for 1 to 2 days; elevate (ESMO/EONS [Perez Fidalgo 2012]). Remaining portion of the vincristine dose should be infused through a separate vein.

Hyaluronidase: If needle/cannula still in place, administer 1 to 6 mL hyaluronidase (150 units/mL) into the existing IV line; the usual dose is 1 mL hyaluronidase for each 1 mL of extravasated drug (ESMO/EONS [Perez Fidalgo 2012]; Schulmeister 2011). If needle/cannula was removed, inject 1 to 6 mL (150 units/mL) subcutaneously in a clockwise manner using 1 mL for each 1 mL of drug extravasated (Schulmeister 2011) or administer 1 mL (150 units/mL) as 5 separate 0.2 mL injections (using a 25-gauge needle) subcutaneously into the extravasation site (Polovich 2009).

Administration: Pediatric

Note: For IV administration only; fatal if given intrathecally; vincristine should NOT be delivered to the patient with any medications intended for central nervous system (ie, intrathecal) administration. Note: In order to prevent inadvertent intrathecal administration, the World Health Organization (WHO) and the Institute for Safe Medical Practices (ISMP) recommend dispensing vincristine in a minibag (rather than a syringe) (ISMP 2020). Vincristine should NOT be prepared during the preparation of any intrathecal medication. After preparation, keep vincristine in a location away from the separate storage location recommended for intrathecal medications.

IV infusion: Administer minibag dose as a short infusion, generally over 5 to 15 minutes (Gilbar 2015); administration via gravity instead of infusion pump has also been utilized (Beaver 2018). Some protocols utilize a 24-hour continuous IV infusion.

Vincristine is a vesicant and should only be administered IV; ensure proper needle or catheter placement prior to and during infusion; avoid extravasation. If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do NOT flush the line); initiate hyaluronidase antidote (see Management of Drug Extravasations for more details); apply dry warm compresses for 20 minutes 4 times a day for 1 to 2 days; elevate extremity (Pérez Fidalgo 2012). Remaining portion of the vincristine dose should be infused through a separate vein.

Hazardous Drugs Handling Considerations

Hazardous agent (NIOSH 2016 [group 1]).

Use appropriate precautions for receiving, handling, storage, preparation, dispensing, transporting, administration, and disposal. Follow NIOSH and USP 800 recommendations and institution-specific policies/procedures for appropriate containment strategy (NIOSH 2016; USP-NF 2020).

Use: Labeled Indications

Acute lymphocytic leukemia: Treatment of acute lymphocytic leukemia.

Hodgkin lymphoma: Treatment of Hodgkin lymphoma.

Neuroblastoma: Treatment of neuroblastoma.

Non-Hodgkin lymphomas: Treatment of non-Hodgkin lymphomas.

Rhabdomyosarcoma: Treatment of rhabdomyosarcoma.

Wilms tumor: Treatment of Wilms tumor.

Use: Off-Label: Adult

Central nervous system tumors (anaplastic oligodendrogliomas/oligoastrocytomas, low-grade gliomas, medulloblastoma, recurrent glioblastoma); Chronic lymphocytic leukemia/small lymphocytic lymphoma with Richter transformation; Ewing sarcoma; Gestational trophoblastic tumors, high risk; Merkel cell carcinoma (advanced or recurrent); Multiple myeloma; Ovarian germ cell tumors; Pheochromocytoma, malignant; Primary CNS lymphoma; Small cell lung cancer (recurrent); Thymoma, advanced

Medication Safety Issues
Sound-alike/look-alike issues:

VinCRIStine may be confused with vinBLAStine, vinorelbine

VinCRIStine conventional may be confused with vinCRIStine liposomal

Oncovin may be confused with Ancobon

High alert medication:

This medication is in a class the Institute for Safe Medication Practices (ISMP) includes among its list of drug classes which have a heightened risk of causing significant patient harm when used in error.

Administration issues:

For IV use only. Fatal if administered by other routes. To prevent fatal inadvertent intrathecal injection, dispense vincristine doses in a flexible plastic container (eg, diluted in 25 to 50 mL of a compatible solution), and NOT a syringe (ISMP 2020). Vincristine should NOT be prepared during the preparation of any medications intended for CNS administration. After preparation, keep vincristine in a location away from the separate storage location recommended for medications intended for CNS administration. Vincristine should NOT be delivered to the patient at the same time with any medications intended for CNS administration.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

<1%: Endocrine & metabolic: SIADH

Frequency not defined:

Cardiovascular: Hypertension, hypotension

Dermatologic: Alopecia (common)

Endocrine & metabolic: Dehydration, hyperuricemia, weight loss

Gastrointestinal: Abdominal cramps, anorexia, constipation (may involve upper colon fecal impaction), diarrhea, intestinal necrosis, intestinal perforation, nausea, oral mucosa ulcer, paralytic ileus, vomiting

Genitourinary: Bladder dysfunction (atony), dysuria

Hematologic & oncologic: Leukopenia

Nervous system: Abnormal gait, abnormal sensory symptoms (loss of), cranial nerve disorder (including impairment of extraocular movement, laryngeal muscle impairment, paresis, vocal cord paralysis), decreased deep tendon reflex, headache, neuritic pain, paresthesia, sensorimotor neuropathy (dysfunction)

Neuromuscular & skeletal: Amyotrophy, foot-drop (including slap gait)

Renal: Polyuria

Miscellaneous: Fever

Postmarketing:

Dermatologic: Skin rash

Endocrine & metabolic: Uric acid nephropathy (acute)

Gastrointestinal: Sore throat

Hematologic & oncologic: Anemia, thrombocytopenia

Nervous system: Ataxia, paralysis, parotid pain, seizure

Neuromuscular & skeletal: Back pain, jaw pain, limb pain, myalgia, ostealgia

Ophthalmic: Blepharoptosis (Hatzipantelis 2015; Revannasiddaiah 2011), cortical blindness (transient), optic atrophy (with blindness)

Respiratory: Acute respiratory distress syndrome

Contraindications

Patients with the demyelinating form of Charcot-Marie-Tooth syndrome

Documentation of allergenic cross-reactivity for drugs in this class is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Warnings/Precautions

Concerns related to adverse effects:

• Extravasation: Vincristine is a vesicant; ensure proper needle or catheter placement prior to and during infusion. Avoid extravasation. Individuals administering should be experienced in vincristine administration. Extravasation may cause significant irritation. If extravasation occurs, discontinue immediately and initiate appropriate extravasation management, including local injection of hyaluronidase and moderate heat application to the affected area. Use a separate vein to complete administration.

• Gastrointestinal effects: Constipation, paralytic ileus, intestinal necrosis and/or perforation may occur; constipation may present as upper colon impaction with an empty rectum (may require flat film of abdomen for diagnosis); generally responds to high enemas and laxatives. All patients should be on a prophylactic bowel management regimen.

• Neurotoxicity: Alterations in mental status such as depression, confusion, or insomnia may occur; neurologic effects are dose-limiting (may require dosage reduction) and may be additive with those of other neurotoxic agents and spinal cord irradiation. Use with caution in patients with pre-existing neuromuscular disease and/or with concomitant neurotoxic agents.

• Respiratory effects: Acute shortness of breath and severe bronchospasm have been reported with vinca alkaloids, usually when used in combination with mitomycin. Onset may be several minutes to hours after vincristine administration and up to 2 weeks after mitomycin. Progressive dyspnea may occur.

• Uric acid nephropathy: Acute uric acid nephropathy has been reported with vincristine.

Disease-related concerns:

• Hepatic impairment: Use with caution in patients with hepatic impairment. Vincristine may be associated with hepatic sinusoidal obstruction syndrome (formerly called veno-occlusive disease), increased risk in children <3 years of age; use with caution in hepatobiliary dysfunction.

Other warnings/precautions:

• For IV use only: For IV administration only; fatal if given by other routes. To prevent administration errors, dispense vincristine diluted in a minibag (ISMP 2020). Vincristine should NOT be prepared during the preparation of any medications intended for CNS administration. After preparation, keep vincristine in a location away from the separate storage location recommended for medications intended for CNS administration. Vincristine should NOT be delivered to the patient at the same time with any medications intended for CNS administration (ASCO/ONS [Neuss 2016]).

Metabolism/Transport Effects

Substrate of CYP3A4 (major), P-glycoprotein/ABCB1 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Clofazimine: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

CYP3A4 Inducers (Strong): May decrease the serum concentration of VinCRIStine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Moderate): May increase the serum concentration of VinCRIStine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Strong): May increase the serum concentration of VinCRIStine. Management: Seek alternatives to this combination when possible. If combined, monitor closely for vincristine toxicities (eg, neurotoxicity, gastrointestinal toxicity, myelosuppression). Risk D: Consider therapy modification

Erdafitinib: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Fexinidazole: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Fluconazole: May increase the serum concentration of VinCRIStine. Risk C: Monitor therapy

Fosphenytoin: May decrease the serum concentration of VinCRIStine. VinCRIStine may decrease the serum concentration of Fosphenytoin. Risk C: Monitor therapy

Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Lenograstim: Antineoplastic Agents may diminish the therapeutic effect of Lenograstim. Management: Avoid the use of lenograstim 24 hours before until 24 hours after the completion of myelosuppressive cytotoxic chemotherapy. Risk D: Consider therapy modification

Lipegfilgrastim: Antineoplastic Agents may diminish the therapeutic effect of Lipegfilgrastim. Management: Avoid concomitant use of lipegfilgrastim and myelosuppressive cytotoxic chemotherapy. Lipegfilgrastim should be administered at least 24 hours after the completion of myelosuppressive cytotoxic chemotherapy. Risk D: Consider therapy modification

MitoMYcin (Systemic): Antineoplastic Agents (Vinca Alkaloids) may enhance the adverse/toxic effect of MitoMYcin (Systemic). Specifically, the risk of pulmonary toxicity may be increased. Risk C: Monitor therapy

NIFEdipine: May increase the serum concentration of VinCRIStine. Risk C: Monitor therapy

Palifermin: May enhance the adverse/toxic effect of Antineoplastic Agents. Specifically, the duration and severity of oral mucositis may be increased. Management: Do not administer palifermin within 24 hours before, during infusion of, or within 24 hours after administration of myelotoxic chemotherapy. Risk D: Consider therapy modification

Phenytoin: May decrease the serum concentration of VinCRIStine. VinCRIStine may decrease the serum concentration of Phenytoin. Management: . Risk C: Monitor therapy

Teniposide: May enhance the neurotoxic effect of VinCRIStine. Risk C: Monitor therapy

Vasopressin: Drugs Suspected of Causing SIADH may enhance the therapeutic effect of Vasopressin. Specifically, the pressor and antidiuretic effects of vasopressin may be increased. Risk C: Monitor therapy

Reproductive Considerations

Patients who could become pregnant should avoid becoming pregnant during vincristine treatment.

The effect of vincristine alone on male and female fertility is not known; available information is from use in combination with other agents. Recommendations are available for fertility preservation in patients treated with anticancer agents (ASCO [Oktay 2018]).

Pregnancy Considerations

Based on data from animal reproduction studies, in utero exposure to vincristine may cause fetal harm. However, use in pregnancy has been described (NTP 2013).

The European Society for Medical Oncology has published guidelines for diagnosis, treatment, and follow-up of cancer during pregnancy; the guidelines recommend referral to a facility with expertise in cancer during pregnancy and encourage a multidisciplinary team (obstetrician, neonatologist, oncology team). In general, if chemotherapy is indicated, it should be avoided in the first trimester and there should be a 3-week time period between the last chemotherapy dose and anticipated delivery, and chemotherapy should not be administered beyond week 33 of gestation (ESMO [Peccatori 2013]).

When multiagent therapy is needed to treat aggressive non-Hodgkin lymphomas during pregnancy, vincristine (as a component of the CHOP [cyclophosphamide, doxorubicin, vincristine, and prednisone] regimen) may be used when indicated (ESMO [Peccatori 2013]; Lishner 2016).

A pregnancy registry is available for all cancers diagnosed during pregnancy at Cooper Health (1-877-635-4499).

Breastfeeding Considerations

It is not known if vincristine is present in breast milk.

Vincristine breast milk concentrations were evaluated in one patient following maternal treatment for stage IV diffuse large B-cell lymphoma at 4 months postpartum. Breast milk was sampled over 21 days. Vincristine was not measurable in breast milk; however, due to the high limit of detection, low concentrations could not be excluded (assay limit not described) (Codacci-Pisanelli 2019).

Due to the potential for serious adverse reactions in the breastfed infant, the decision to discontinue vincristine or to discontinue breastfeeding should consider the benefits of treatment to the mother.

Monitoring Parameters

Monitor serum electrolytes (sodium), hepatic function tests, CBC with differential, serum uric acid. Monitor for signs or symptoms of hepatic sinusoidal obstruction syndrome, including bilirubin >1.4 mg/dL, unexplained weight gain, ascites, hepatomegaly, or unexplained right upper quadrant pain (Arndt 2004). Monitor infusion site. Perform neurologic examination, monitor for constipation/ileus and for signs/symptoms of peripheral neuropathy.

The American Society of Clinical Oncology hepatitis B virus (HBV) screening and management provisional clinical opinion (ASCO [Hwang 2020]) recommends HBV screening with hepatitis B surface antigen, hepatitis B core antibody, total Ig or IgG, and antibody to hepatitis B surface antigen prior to beginning (or at the beginning of) systemic anticancer therapy; do not delay treatment for screening/results. Detection of chronic or past HBV infection requires a risk assessment to determine antiviral prophylaxis requirements, monitoring, and follow-up.

Mechanism of Action

Vincristine binds to tubulin and inhibits microtubule formation, therefore, arresting the cell at metaphase by disrupting the formation of the mitotic spindle; it is specific for the M and S phases. Vincristine may also interfere with nucleic acid and protein synthesis by blocking glutamic acid utilization.

Pharmacokinetics

Note: In pediatric patients, significant intrapatient and interpatient variability has been reported (Gidding 1999).

Distribution: Rapidly removed from bloodstream and tightly bound to tissues; penetrates blood-brain barrier poorly

Metabolism: Extensively hepatic, via CYP3A4

Half-life elimination: Terminal: 85 hours (range: 19 to 155 hours)

Excretion: Feces (~80%); urine (10% to 20%; <1% as unchanged drug)

Clearance: In pediatric patients, correlation with diagnosis has been reported; clearance in patients with ALL and non-Hodgkin lymphoma higher than Wilms’ tumor (Gidding 1999):

Infants: Vincristine clearance is lower compared to children; more closely related to body weight than to body surface area (Crom1994)

Children and Adolescents 2 to 18 years: Reported means: 357 to 482 mL/minute/m2; some suggest faster clearance in children <10 years of age than in adolescents (Crom 1994); however, more recent data does not support this finding nor a dosage reduction in adolescent patients (Frost 2003; Gidding 1999)

Pricing: US

Solution (Vincasar PFS Intravenous)

1 mg/mL (per mL): $18.06

Solution (vinCRIStine Sulfate Intravenous)

1 mg/mL (per mL): $6.90 - $7.01

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Brand Names: International
  • Alcavixin (PH);
  • Alcrist (IN);
  • Biocristin (IN);
  • Cellicristin (LB);
  • Citomid (CR, DO, GT, HN, NI, PA, SV);
  • Citomid RU (MX);
  • Cristol (ET);
  • Criston (BD);
  • Cristovin (IL);
  • Crivosin (CR, DO, GT, HN, MX, NI, PA, SV);
  • Cytocristin (BG, IN, VN, ZW);
  • Dabaz (BR);
  • Faulcris (NO);
  • Kyocristine (JP);
  • Oncocristin (CO, PE);
  • Oncovin (AE, AT, BF, BJ, BR, CH, CI, CZ, DE, DK, EE, ET, FI, FR, GB, GH, GM, GN, GR, HR, IE, IT, KE, LR, LU, MA, ML, MR, MT, MU, MW, MX, NE, NG, NL, PK, PL, PT, RU, SA, SC, SD, SE, SK, SL, SN, TH, TN, TR, TZ, UG, ZA, ZM, ZW);
  • Rasteo (ID);
  • Tecnocris (BR);
  • Vinces (AR);
  • Vincran (KR);
  • Vincrina (PY);
  • Vincrisin (BE);
  • Vincristin (HU, PL);
  • Vincristina (IT);
  • Vincristine Delta West (HR);
  • Vincristine Sulfate (PL);
  • Vincristine-David Bull (LU);
  • Vinracine (EG, HK, MY, SG);
  • Vinstin (LK);
  • Vintec (MX)


For country abbreviations used in Lexicomp (show table)
  1. <800> Hazardous Drugs—Handling in Healthcare Settings. United States Pharmacopeia and National Formulary (USP 43-NF 38). Rockville, MD: United States Pharmacopeia Convention; 2020:74-92.
  2. American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227-2246. [PubMed 26446832]
  3. Appel BE, Chen L, Buxton AB, et al. Minimal treatment of low-risk, pediatric lymphocyte-predominant hodgkin lymphoma: a report from the Children's Oncology Group. J Clin Oncol. 2016;34(20):2372-2379. [PubMed 27185849]
  4. Arndt C, Hawkins, D, Anderson JR, et al, “Age is a Risk Factor for Chemotherapy-Induced Hepatopathy With Vincristine, Dactinomycin and Cyclophosphamide,” J Clin Oncol, 2004, 22(10):1894-901. [PubMed 15143082]
  5. Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007, p 102, 174.
  6. Ater JL, Zhou T, Holmes E, et al. Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children's Oncology Group. J Clin Oncol. 2012;30(21):2641-2647. [PubMed 22665535]
  7. Avramis VI, Sencer S, Periclou AP, et al, “A Randomized Comparison of Native Escherichia coli Asparaginase and Polyethylene Glycol Conjugated Asparaginase for Treatment of Children With Newly Diagnosed Standard-Risk Acute Lymphoblastic Leukemia: A Children's Cancer Group Study,” Blood, 2002, 99(6):1986-94. [PubMed 11877270]
  8. Beaver C. Vincristine minibag administration: a quality improvement project to minimize medical errors. Clin J Oncol Nurs. 2018;22(6):669-672. [PubMed 30452001]
  9. Beijnen JH, Vendrig DE, Underberg WJ. Stability of vinca alkaloid anticancer drugs in three commonly used infusion fluids. J Parenter Sci Technol. 1989;43(2):84-87. [PubMed 2709240]
  10. Bostrom BC, Sensel MR, Sather HN, et al, “Dexamethasone Versus Prednisone and Daily Oral Versus Weekly Intravenous Mercaptopurine for Patients With Standard-Risk Acute Lymphoblastic Leukemia: A Report from the Children's Cancer Group,” Blood, 2003, 101(10):3809-17. [PubMed 12531809]
  11. Bowman WP, Shuster JJ, Cook B, et al, “Improved Survival for Children With B-Cell Acute Lymphoblastic Leukemia and Stage IV Small Noncleaved-Cell Lymphoma: A Pediatric Oncology Group Study,” J Clin Oncol, 1996, 14(4):1252-61. [PubMed 8648381]
  12. Brada M, Stenning S, Gabe R, et al. Temozolomide versus procarbazine, lomustine, and vincristine in recurrent high-grade glioma. J Clin Oncol. 2010;28(30):4601-4608. doi: 10.1200/JCO.2009.27.1932. [PubMed 20855843]
  13. Buckner JC, Shaw EG, Pugh SL, et al. Radiation plus procarbazine, CCNU, and vincristine in low-grade glioma. N Engl J Med 2016;374(14):1344-1355. doi: 10.1056/NEJMoa1500925. [PubMed 27050206]
  14. Cairncross G, Berkey B, Shaw E, et al, “Phase III Trial of Chemotherapy Plus Radiotherapy Compared With Radiotherapy Alone for Pure and Mixed Anaplastic Oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402,” J Clin Oncol, 2006, 24(18):2707-14. [PubMed 16782910]
  15. Cairncross G, Wang M, Shaw E, et al. Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. J Clin Oncol. 2013;31(3):337-343. [PubMed 23071247]
  16. Cairo MS, Gerrard M, Sposto R, et al. Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents. Blood. 2007;109(7):2736-2743. [PubMed 17138821]
  17. Chi SN, Gardner SL, Levy AS, et al. Feasibility and response to induction chemotherapy intensified with high-dose methotrexate for young children with newly diagnosed high-risk disseminated medulloblastoma. J Clin Oncol. 2004;22(24):4881-4887. [PubMed 15611503]
  18. Codacci-Pisanelli G, Honeywell RJ, Asselin N, et al. Breastfeeding during R-CHOP chemotherapy: please abstain! Eur J Cancer. 2019;119:107-111. doi:10.1016/j.ejca.2019.07.012 [PubMed 31437753]
  19. Coiffier B, Lepage E, Briere J, et al, “CHOP Chemotherapy Plus Rituximab Compared With CHOP Alone in Elderly Patients With Diffuse Large-B-Cell Lymphoma,” N Engl J Med, 2002, 346(4):235-42. [PubMed 11807147]
  20. Crist WM, Anderson JR, Meza JL, et al, "Intergroup Rhabdomyosarcoma Study-IV: Results for Patients With Nonmetastatic Disease," J Clin Oncol, 2001, 19(12):3091-102. [PubMed 11408506]
  21. Crom WR, deGraaf SS, Synold T, et al, “Pharmacokinetics of Vincristine in Children and Adolescents With Acute Lymphocytic Leukemia,” J Pediatr, 1994, 125(4):642-9. [PubMed 7931891]
  22. DeAngelis LM, Seiferheld W, Schold SC, et al. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93-10. J Clin Oncol. 2002;20(24):4643-4648. [PubMed 12488408]
  23. DeAngelo DJ, Stevenson KE, Dahlberg SE, et al. Long-term outcome of a pediatric-inspired regimen used for adults aged 18-50 years with newly diagnosed acute lymphoblastic leukemia. Leukemia. 2015;29(3):526-534. doi: 10.1038/leu.2014.229. [PubMed 25079173]
  24. Diehl V, Franklin J, Pfreundschuh M, et al, “Standard and Increased-Dose BEACOPP Chemotherapy Compared With COPP-ABVD for Advanced Hodgkin's Disease,” N Engl J Med, 2003, 348(24):2386-95. [PubMed 12802024]
  25. Dunleavy K, Pittaluga S, Maeda LS, et al. Dose-adjusted EPOCH-rituximab therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013;368(15):1408-1416. [PubMed 23574119]
  26. Escobar PF, Lurain JR, Singh DK, et al, “Treatment of High-Risk Gestational Trophoblastic Neoplasia With Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide, and Vincristine Chemotherapy,” Gynecol Oncol, 2003, 91(3):552-7. [PubMed 14675675]
  27. Eiriksson L, Dean E, Sebastianelli A, et al. Guideline no. 408: management of gestational trophoblastic diseases. J Obstet Gynaecol Can. 2021;43(1):91-105.e1. doi:10.1016/j.jogc.2020.03.001 [PubMed 33384141]
  28. Evans AE, Land VJ, Newton WA, Randolph JG, Sather HN, Tefft M. Combination chemotherapy (vincristine, adriamycin, cyclophosphamide, and 5-fluorouracil) in the treatment of children with malignant hepatoma. Cancer. 1982;50(5):821-826. [PubMed 6284345]
  29. Fenig E, Brenner B, Katz A, Rakovsky E, Hana MB, Sulkes A. The role of radiation therapy and chemotherapy in the treatment of Merkel cell carcinoma. Cancer. 1997;80(5):881-885. [PubMed 9307187]
  30. Floyd J, Mirza I, Sachs B, et al, "Hepatotoxicity of Chemotherapy," Semin Oncol, 2006, 33(1):50-67. [PubMed 16473644]
  31. Floyd JD, Nguyen DT, Lobins RL, et al, "Cardiotoxicity of Cancer Therapy," J Clin Oncol. 2005, 23(30):7685-96. [PubMed 16234530]
  32. Follows GA, Ardeshna KM, Barrington SF, et al. Guidelines for the first line management of classical Hodgkin lymphoma. Br J Haematol. 2014;166(1):34-49. doi:10.1111/bjh.12878 [PubMed 24712411]
  33. Fornasiero A, Daniele O, Ghiotto C, et al, “Chemotherapy for Invasive thymoma. A 13-year Experience,” Cancer, 1991, 68(1):30-3. [PubMed 2049749]
  34. Friedman DL, Chen L, Wolden S, et al. Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly diagnosed intermediate-risk hodgkin lymphoma: a report from the Children's Oncology Group Study AHOD0031. J Clin Oncol. 2014;32(32):3651-3658. [PubMed 25311218]
  35. Friedman DL, Himelstein B, Shields CL, et al, "Chemoreduction and Local Ophthalmic Therapy for Intraocular Retinoblastoma," J Clin Oncol, 2000, 18(1):12-7. [PubMed 10623688]
  36. Frost BM, Lönnerholm G, Koopmans P, et al, "Vincristine in Childhood Leukaemia: No Pharmacokinetic Rationale for Dose Reduction in Adolescents," Acta Paediatr, 2003, 92(5):551-7. [PubMed 12839283]
  37. García-Suárez J, Bañas H, Arribas I, De Miguel D, Pascual T, Burgaleta C. Dose-adjusted EPOCH plus rituximab is an effective regimen in patients with poor-prognostic untreated diffuse large B-cell lymphoma: results from a prospective observational study. Br J Haematol. 2007;136(2):276-285. [PubMed 17233819]
  38. Gidding CE, Meeuwsen-de Boer GJ, Koopmans P, Uges DR, Kamps WA, de Graaf SS. Vincristine pharmacokinetics after repetitive dosing in children. Cancer Chemother Pharmacol. 1999;44(3):203-209. [PubMed 10453721]
  39. Gilbar P, Chambers CR, Larizza M. Medication safety and the administration of intravenous vincristine: international survey of oncology pharmacists. J Oncol Pharm Pract. 2015;21(1):10-18. [PubMed 24418800]
  40. Giulino-Roth L, O'Donohue T, Chen Z, et al. Outcomes of adults and children with primary mediastinal B-cell lymphoma treated with dose-adjusted EPOCH-R. Br J Haematol. 2017;179(5):739-747. [PubMed 29082519]
  41. Goldman S, Smith L, Anderson JR, et al. Rituximab and FAB/LMB 96 chemotherapy in children with Stage III/IV B-cell non-Hodgkin lymphoma: a Children's Oncology Group report. Leukemia. 2013;27(5):1174-1177. [PubMed 22940833]
  42. Goldman S, Smith L, Galardy P, et al. Rituximab with chemotherapy in children and adolescents with central nervous system and/or bone marrow-positive Burkitt lymphoma/leukaemia: a Children's Oncology Group Report. Br J Haematol. 2014;167(3):394-401. [PubMed 25066629]
  43. Granowetter L, Womer R, Devidas M, et al, "Dose-Intensified Compared With Standard Chemotherapy for Nonmetastatic Ewing Sarcoma Family of Tumors: A Children's Oncology Group Study," J Clin Oncol, 2009, 27(15):2536-41. [PubMed 19349548]
  44. Green DM, Breslow NE, Beckwith JB, et al, “Effect of Duration of Treatment on Treatment Outcome and Cost of Treatment for Wilms' Tumor: A Report From the National Wilms' Tumor Study Group,” J Clin Oncol, 1998, 16(12):3744-51. [PubMed 9850017]
  45. Green DM, Cotton CA, Malogolowkin M, et al, “Treatment of Wilms Tumor Relapsing After Initial Treatment With Vincristine and Actinomycin D: A Report From the National Wilms Tumor Study Group,” Pediatr Blood Cancer, 2007, 48(5):493-9. [PubMed 16547940]
  46. Grier HE, Krailo MD, Tarbell NJ, et al, “Addition of Ifosfamide and Etoposide to Standard Chemotherapy for Ewing's Sarcoma and Primitive Neuroectodermal Tumor of Bone,” N Engl J Med, 2003, 348(8):694-701. [PubMed 12594313]
  47. Griggs JJ, Bohlke K, Balaban EP, et al. Appropriate systemic therapy dosing for obese adult patients with cancer: ASCO guideline update. J Clin Oncol. 2021;39(18):2037-2048. doi:10.1200/JCO.21.00471 [PubMed 33939491]
  48. Hatzipantelis E, Kyriakidis I, Pavlou E, Pavlidou E. Bilateral Eyelid Ptosis, Attributed to Vincristine, Treated Successfully with Pyridoxine and Thiamine in a Child with Acute Lymphoblastic Leukemia. Toxicol Int. 2015;22(1):162-164. doi:10.4103/0971-6580.172275 [PubMed 26862280]
  49. Hiddemann W, Kneba M, Dreyling M, et al. Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP alone: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group. Blood. 2005;106(12):3725-3732. doi: 10.1182/blood-2005-01-0016. [PubMed 16123223]
  50. Hong WK, Nicaise C, Larson R, et al, “Etoposide Combined With Cyclophosphamide Plus Vincristine Compared With Doxorubicin Plus Cyclophosphamide Plus Vincristine and With High-Dose Cyclophosphamide Plus Vincristine in the Treatment of Small-Cell Carcinoma of the Lung: A Randomized Trial of the Bristol Lung Cancer Study Group,” J Clin Oncol, 1989, 7(4):450-6. [PubMed 2538577]
  51. Horning SJ, Hoppe RT, Breslin S, et al, “Stanford V and Radiotherapy for Locally Extensive and Advanced Hodgkin's Disease: Mature Results of a Prospective Clinical Trial,” J Clin Oncol, 2002, 20(3):630-7. [PubMed 11821442]
  52. Horning SJ, Williams J, Bartlett NL, et al, “Assessment of the Stanford V Regimen and Consolidative Radiotherapy for Bulky and Advanced Hodgkin's Disease: Eastern Cooperative Oncology Group Pilot Study E1492,” J Clin Oncol, 2000, 18(5):972-80. [PubMed 10694546]
  53. Huang H, Abraham J, Hung E, et al. Treatment of malignant pheochromocytoma/paraganglioma with cyclophosphamide, vincristine, and dacarbazine: recommendation from a 22-year follow-up of 18 patients. Cancer. 2008;113(8):2020-2028. [PubMed 18780317]
  54. Huguet F, Chevret S, Lequay T, et al; Group of Research on Adult ALL (GRAALL). Intensified therapy of acute lymphoblastic leukemia in adults: report of the randomized GRAALL-2005 clinical trial. J Clin Oncol. 2018;36(24):2514-2523. doi: 10.1200/JCO.2017.76.8192. [PubMed 29863974]
  55. Huguet F, Leguay T, Raffoux E, et al. Pediatric-inspired therapy in adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: the GRAALL-2003 study. J Clin Oncol. 2009;27(6):911-918. [PubMed 19124805]
  56. Hwang JP, Feld JJ, Hammond SP, et al. Hepatitis B virus screening and management for patients with cancer prior to therapy: ASCO provisional clinical opinion update. J Clin Oncol. 2020;38(31):3698-3715. doi:10.1200/JCO.20.01757 [PubMed 32716741]
  57. Institute for Safe Medicine Practices (ISMP). ISMP Targeted Medication Safety Best Practices for Hospitals. https://www.ismp.org/sites/default/files/attachments/2020-02/2020-2021%20TMSBP-%20FINAL_1.pdf. Published February 21, 2020. Accessed January 11, 2022.
  58. Kantarjian H, Thomas D, O'Brien S, et al, “Long-Term Follow-Up Results of Hyperfractionated Cyclophosphamide, Vincristine, Doxorubicin, and Dexamethasone (Hyper-CVAD), A Dose-Intensive Regimen, in Adult Acute Lymphocytic Leukemia,” Cancer, 2004, 101(12):2788-801. [PubMed 15481055]
  59. Kelly KM, Hutchinson RJ, Sposto R, et al, "Feasibility of Upfront Dose-Intensive Chemotherapy in Children With Advanced-Stage Hodgkin's Lymphoma: Preliminary Results From the Children's Cancer Group Study CCG-59704," Ann Oncol, 2002, 13(Suppl 1):107-11. [PubMed 12078889]
  60. Kim DY, Joo YD, Lim SN, et al. Nilotinib combined with multiagent chemotherapy for newly diagnosed Philadelphia-positive acute lymphoblastic leukemia. Blood. 2015;126(6):746-756. [PubMed 26065651]
  61. Kintzel PE and Dorr RT, “Anticancer Drug Renal Toxicity and Elimination: Dosing Guidelines for Altered Renal Function,” Cancer Treat Rev, 1995, 21(1):33-64. [PubMed 7859226]
  62. Kolb EA, Kushner BH, Gorlick R, et al, “Long-Term Event-Free Survival After Intensive Chemotherapy for Ewing's Family of Tumors in Children and Young Adults,” J Clin Oncol, 2003, 21(18):3423-30. [PubMed 12972518]
  63. Krens SD, Lassche G, Jansman FGA, et al. Dose recommendations for anticancer drugs in patients with renal or hepatic impairment. Lancet Oncol. 2019;20(4):e200-e207. doi:10.1016/S1470-2045(19)30145-7 [PubMed 30942181]
  64. Kushner BH, Kramer K, Modak S, Qin LX, Cheung NK. Differential impact of high-dose cyclophosphamide, topotecan, and vincristine in clinical subsets of patients with chemoresistant neuroblastoma. Cancer. 2010;116(12):3054-3060. [PubMed 20564411]
  65. Kushner BH, LaQuaglia MP, Bonilla MA, et al, “Highly Effective Induction Therapy for Stage 4 Neuroblastoma in Children Over 1 Year of Age,” J Clin Oncol, 1994, 12(12):2607-13. [PubMed 7527454]
  66. Larsen EC, Devidas M, Chen S, et al. Dexamethasone and high-dose methotrexate improve outcome for children and young adults with high-risk B-acute lymphoblastic leukemia: a report from Children's Oncology Group Study AALL0232. J Clin Oncol. 2016;34(20):2380-2388. [PubMed 27114587]
  67. Larson RA, Dodge RK, Burns CP, et al, “A Five-Drug Remission Induction Regimen With Intensive Consolidation for Adults With Acute Lymphoblastic Leukemia: Cancer and Leukemia Group B Study 8811,” Blood, 1995, 85(8):2025-37. [PubMed 7718875]
  68. Legha SS, "Vincristine Neurotoxicity. Pathophysiology and Management," Med Toxicol, 1986, 1(6):421-7. [PubMed 3540519]
  69. Levin VA, Uhm JH, Jaeckle KA, et al. Phase III randomized study of postradiotherapy chemotherapy with alpha-difluoromethylornithine-procarbazine, N-(2-chloroethyl)-N’-cyclohexyl-N-nitrosurea, vincristine (DFMO-PCV) versus PCV for glioblastoma multiforme. Clin Cancer Res. 2000;6(10):3878-3884. [PubMed 11051233]
  70. Lishner M, Avivi I, Apperley JF, et al. Hematologic malignancies in pregnancy: management guidelines from an international consensus meeting. J Clin Oncol. 2016;34(5):501-508. doi:10.1200/JCO.2015.62.4445 [PubMed 26628463]
  71. Lurain JR, Singh DK, Schink JC. Primary treatment of metastatic high-risk gestational trophoblastic neoplasia with EMA-CO chemotherapy. J Reprod Med. 2006;51(10):767-772 [PubMed 17086804]
  72. Magrath I, Adde M, Shad A, et al, “Adults and Children With Small Non-Cleaved-Cell Lymphoma Have a Similar Excellent Outcome When Treated With the Same Chemotherapy Regimen,” J Clin Oncol, 1996, 14(3):925-34. [PubMed 8622041]
  73. Marcus R, Davies A, Ando K, et al. Obinutuzumab for the first-line treatment of follicular lymphoma. N Engl J Med. 2017;377(14):1331-1344. [PubMed 28976863]
  74. Marcus R, Imrie K, Belch A, et al, “CVP Chemotherapy Plus Rituximab Compared With CVP as First-Line Treatment for Advanced Follicular Lymphoma,” Blood, 2005, 105(4):1417-23. [PubMed 15494430]
  75. McCune JS and Lindley C, "Appropriateness of Maximum-Dose Guidelines for Vincristine," Am J Health Syst Pharm, 1997, 54(15):1755-8. [PubMed 9262750]
  76. Mead GM, Barrans SL, Qian W, et al, "A Prospective Clinicopathologic Study of Dose-Modified CODOX-M/IVAC in Patients With Sporadic Burkitt Lymphoma Defined Using Cytogenetic and Immunophenotypic Criteria (MRC/NCRI LY10 Trial)," Blood, 2008, 112(6):2248-60. [PubMed 18612102]
  77. Mead GM, Sydes MR, Walewski J, et al, "An International Evaluation of CODOX-M and CODOX-M Alternating With IVAC in Adult Burkitt's Lymphoma: Results of United Kingdom Lymphoma Group LY06 Study," Ann Oncol, 2002, 13(8):1264-74. [PubMed 12181251]
  78. Michelagnoli MP, Bailey CC, Wilson I, Livingston J, Kinsey SE. Potential salvage therapy for inadvertent intrathecal administration of vincristine. Br J Haematol. 1997;99(2):364-367. [PubMed 9375755]
  79. Moccia AA, Schaff K, Hoskins P, et al. R-CHOP with etoposide substituted for doxorubicin (R-CEOP): excellent outcome in diffuse large B cell lymphoma for patients with a contraindication to anthracyclines. Blood. 2009;114(22), abstract 408.
  80. Morris PG, Correa DD, Yahalom J, et al. Rituximab, methotrexate, procarbazine, and vincristine followed by consolidation reduced-dose whole-brain radiotherapy and cytarabine in newly diagnosed primary CNS lymphoma: final results and long-term outcome. J Clin Oncol. 2013;31(31):3971-3979. [PubMed 24101038]
  81. Moore A and Pinkerton R, "Vincristine: Can Its Therapeutic Index Be Enhanced?" Pediatr Blood Cancer, 2009, 53(7):1180-7. [PubMed 19588521]
  82. Morgan C, Tillett T, Braybrooke J, et al, "Management of Uncommon Chemotherapy-Induced Emergencies," Lancet Oncol, 2011, 12(8):806-14. [PubMed 21276754]
  83. National Toxicology Program (NTP) - US Department of Health and Human Services. Cancer chemotherapy use during pregnancy. http://ntp.niehs.nih.gov/pubhealth/hat/noms/chemo/index.html. Published May 1, 2013.
  84. Neuss MN, Gilmore TR, Belderson KM, et al. 2016 updated American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards, including standards for pediatric oncology. J Oncol Pract. 2016;12(12):1262-1271. doi:10.1200/JOP.2016.017905 [PubMed 27868581]
  85. Oktay K, Harvey BE, Partridge AH, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36(19):1994-2001. doi:10.1200/JCO.2018.78.1914 [PubMed 29620997]
  86. Omuro A, Correa DD, DeAngelis LM, et al. R-MPV followed by high-dose chemotherapy with TBC and autologous stem-cell transplant for newly diagnosed primary CNS lymphoma. Blood. 2015;125(9):1403-1410. [PubMed 25568347]
  87. Ortega JA, Douglass EC, Feusner JH, et al. Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group. J Clin Oncol. 2000;18(14):2665-2675. [PubMed 10894865]
  88. Packer RJ, Gajjar A, Vezina G, et al. Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol. 2006;24(25):4202-4208. doi: 10.1200/JCO.2006.06.4980. [PubMed 16943538]
  89. Peccatori FA, Azim HA Jr, Orecchia R, et al. Cancer, pregnancy and fertility: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(suppl 6):vi160-vi170. doi:10.1093/annonc/mdt199 [PubMed 23813932]
  90. Perez Fidalgo JA, García Fabregat L, Cervantes A, et al, “Management of Chemotherapy Extravasation: ESMO-EONS Clinical Practice Guidelines,” Ann Oncol, 2012, 23(Suppl 7):167-73. [PubMed 22997449]
  91. Pfreundschuh M, Trümper L, Kloess M, et al. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood. 2004;104(3):626-633. doi: 10.1182/blood-2003-06-2094. [PubMed 14982884]
  92. Pieters R, Schrappe M, De Lorenzo P, et al. A treatment protocol for infants younger than 1 year with acute lymphoblastic leukaemia (Interfant-99): an observational study and a multicentre randomised trial. Lancet. 2007;370(9583):240-250. [PubMed 17658395]
  93. Polovich M, Whitford JN and Olsen M, Chemotherapy and Biotherapy Guidelines and Recommendations for Practice, 3rd ed, Pittsburgh, PA: Oncology Nursing Society, 2009.
  94. Pritchard J, Imeson J, Barnes J, et al, "Results of the United Kingdom Children's Cancer Study Group First Wilms' Tumor Study," J Clin Oncol, 1995, 13(1):124-33. [PubMed 7799012]
  95. Qweider M, Gilsbach JM, Rohde V. Inadvertent intrathecal vincristine administration: a neurosurgical emergency. Case report. J Neurosurg Spine. 2007;6(3):280-283. [PubMed 17355029]
  96. Raney RB, Walterhouse DO, Meza JL, et al. Results of the Intergroup Rhabdomyosarcoma Study Group D9602 protocol, using vincristine and dactinomycin with or without cyclophosphamide and radiation therapy, for newly diagnosed patients with low-risk embryonal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2011;29(10):1312-1318. [PubMed 21357783]
  97. Ravandi F, O'Brien S, Thomas D, et al. First report of phase 2 study of dasatinib with hyper-CVAD for the frontline treatment of patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia. Blood. 2010;116(12):2070-2077. [PubMed 20466853]
  98. Revannasiddaiah S, Bhattacharyya T. Vincristine-induced unilateral ptosis with serendipitous response to modafinil. BMJ Case Rep. 2011;2011:bcr0720103178. Published 2011 May 3. doi:10.1136/bcr.07.2010.3178 [PubMed 22696700]
  99. Reiter A, Schrappe M, Tiemann M, et al, “Improved Treatment Results in Childhood B-Cell Neoplasms With Tailored Intensification of Therapy: A Report of the Berlin-Frankfurt-Münster Group Trial NHL-BFM 90,” Blood, 1999, 94(10):3294-306. [PubMed 10552938]
  100. Rifkin RM, Gregory SA, Mohrbacher A, et al, “Pegylated Liposomal Doxorubicin, Vincristine, and Dexamethasone Provide Significant Reduction in Toxicity Compared With Doxorubicin, Vincristine, and Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma: A Phase III Multicenter Randomized Trial,” Cancer, 2006, 106(4):848-58. [PubMed 16404741]
  101. Rizzieri DA, Johnson JL, Byrd JC, et al; Alliance for Clinical Trials In Oncology (ACTION). Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and leukemia group B study 10 002. Br J Haematol. 2014;165(1);102-111. doi: 10.1111/bjh.12736. [PubMed 24428673]
  102. Rodriguez-Galindo C, Wilson MW, Haik BG, et al, "Treatment of Intraocular Retinoblastoma With Vincristine and Carboplatin," J Clin Oncol, 2003, 21(10):2019-25. [PubMed 12743157]
  103. Rousselot P, Coudé MM, Gokbuget N, et al. Dasatinib and low-intensity chemotherapy in elderly patients with Philadelphia chromosome-positive ALL. Blood. 2016;128(6):774-782. [PubMed 27121472]
  104. Rowe JM, Buck G, Burnett AK, et al; ECOG; MRC/NCRI Adult Leukemia Working Party. Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood. 2005;106(12): 3760-3767. doi: 10.1182/blood-2005-04-1623. [PubMed 16105981]
  105. Rubie H, Coze C, Plantaz D, et al. Localised and unresectable neuroblastoma in infants: excellent outcome with low-dose primary chemotherapy. Br J Cancer. 2003;89(9):1605-1609. [PubMed 14583756]
  106. Rubie H, De Bernardi B, Gerrard M, et al. Excellent outcome with reduced treatment in infants with nonmetastatic and unresectable neuroblastoma without MYCN amplification: results of the prospective INES 99.1. J Clin Oncol. 2011;29(4):449-455. [PubMed 21172879]
  107. Rubie H, Michon J, Plantaz D, et al, “Unresectable Localized Neuroblastoma: Improved Survival After Primary Chemotherapy Including Carboplatin-Etoposide. Neuroblastoma Study Group of the Societe Francaise d'Oncologie Pediatrique (SFOP),” Br J Cancer, 1998, 77(12):2310-7. [PubMed 9649151]
  108. Rubie H, Plantaz D, Coze C, et al, "Localised and Unresectable Neuroblastoma in Infants: Excellent Outcome With Primary Chemotherapy. Neuroblastoma Study Group, Société Française d'Oncologie Pédiatrique," Med Pediatr Oncol, 2001, 36(1):247-50.S [PubMed 11464897]
  109. Schmitz N, Trümper L, Ziepert M, et al. Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group. Blood. 2010;116(18):3418-3425. [PubMed 20660290]
  110. Schulmeister L, "Extravasation Management: Clinical Update," Semin Oncol Nurs, 2011, 27(1):82-90. [PubMed 21255716]
  111. Schwartz CL, Constine LS, Villaluna D, et al. A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: the results of P9425. Blood. 2009;114(10):2051-2059. [PubMed 19584400]
  112. Seif AE, Naranjo A, Baker DL, et al. A pilot study of tandem high-dose chemotherapy with stem cell rescue as consolidation for high-risk neuroblastoma: Children's Oncology Group study ANBL00P1. Bone Marrow Transplant. 2013;48(7):947-952. [PubMed 23334272]
  113. Shah GD, Yahalom J, Correa DD, et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol. 2007;25(30):4730-4735. doi: 10.1200/JCO.2007.12.5062. [PubMed 17947720]
  114. Shaw EG, Wang M, Coons SW, et al. Randomized trial of radiation therapy plus procarbazine, lomustine, and vincristine chemotherapy for supratentorial adult low-grade glioma: initial results of RTOG 9802. J Clin Oncol. 2012;30(25):3065-3070. doi: 10.1200/JCO.2011.35.8598. [PubMed 22851558]
  115. Shields CL, Honavar SG, Meadows AT, et al, "Chemoreduction for Unilateral Retinoblastoma," Arch Ophthalmol, 2002, 120(12):1653-8. [PubMed 12470138]
  116. Slayton RE, Park RC, Silverberg SG, et al, “Vincristine, Dactinomycin, and Cyclophosphamide in the Treatment of Malignant Germ Cell Tumors of the Ovary. A Gynecologic Oncology Group Study (A Final Report),” Cancer, 1985, 56(2):243-8. [PubMed 2988740]
  117. Stefanou A and Dooley M, “Simple Method to Eliminate the Risk of Inadvertent Intrathecal Vincristine Administration,” J Clin Oncol, 2006, 21(10):2044. [PubMed 12743160]
  118. Stock W, Luger SM, Advani AS, et al. A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: results of CALGB 10403. Blood. 2019;133(14):1548-1559. doi: 10.1182/blood-2018-10-881961. [PubMed 30658992]
  119. Superfin D, Iannucci AA, and Davies AM, “Commentary: Oncologic Drugs in Patients With Organ Dysfunction: A Summary,” Oncologist, 2007, 12(9):1070-83. [PubMed 17914077]
  120. Sussman DA, Escalona-Benz E, Benz MS, et al, "Comparison of Retinoblastoma Reduction for Chemotherapy vs External Beam Radiotherapy," Arch Ophthalmol, 2003, 121(7):979-84. [PubMed 12860801]
  121. Tai PT, Yu E, Winquist E, et al. Chemotherapy in neuroendocrine/Merkel cell carcinoma of the skin: case series and review of 204 cases. J Clin Oncol. 2000;18(12):2493-2499. doi: 10.1200/JCO.2000.18.12.2493. [PubMed 10856110]
  122. Thomas DA, Faderl S, Cortes J, et al. Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate. Blood. 2004;103(12):4396-4407. [PubMed 14551133]
  123. Thomas DA, Faderi S, O’Brien S, et al, “Chemoimmunotherapy With Hyper-CVAD Plus Rituximab for the Treatment of Adult Burkitt and Burkitt-Type Lymphoma or Acute Lymphoblastic Leukemia,” Cancer, 2006, 106(7):1569-80. [PubMed 16502413]
  124. Tsimberidou AM, Kantarjian HM, Cortes J, et al. Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte-macrophage-colony stimulating factor (GM-CSF) alternating with methotrexate and cytarabine plus rituximab and GM-CSF in patients with Richter syndrome or fludarabine-refractory chronic lymphocytic leukemia. Cancer. 2003;97(7):1711-1720. doi: 10.1002/cncr.11238. [PubMed 12655528]
  125. Tsimberidou AM, O’Brien S, Khouri I, et al. Clinical outcomes and prognostic factors in patients with Richter’s syndrome treated with chemotherapy or chemoimmunotherapy with or without stem-cell transplantation. J Clin Oncol. 2006;24(15):2343-2351. doi: 10.1200/JCO.2005.05.0187. [PubMed 16710033]
  126. US Department of Health and Human Services; Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health. NIOSH list of antineoplastic and other hazardous drugs in healthcare settings 2016. http://www.cdc.gov/niosh/topics/antineoplastic/pdf/hazardous-drugs-list_2016-161.pdf. Updated September 2016. Accessed October 5, 2016.
  127. van den Bent MJ, Brandes AA, Taphoorn MJ, et al. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. J Clin Oncol. 2013;31(3):344-350. [PubMed 23071237]
  128. van den Bent MJ, Carpentier AF, Brandes AA, et al, “Adjuvant Procarbazine, Lomustine, and Vincristine Improves Progression-Free Survival But Not Overall Survival in Newly Diagnosed Anaplastic Oligodendrogliomas and Oligoastrocytomas: A Randomized European Organisation for Research and Treatment of Cancer Phase III Trial,” J Clin Oncol, 2006, 24(18):2715-22. [PubMed 16782911]
  129. Vincasar PFS (vincristine sulfate) [prescribing information]. Parsippany, NJ: Teva Pharmaceuticals USA, Inc; September 2020.
  130. Vincristine sulfate [prescribing information]. Lake Forest, IL: Hospira Inc; January 2021.
  131. von Pawel J, Schiller JH, Shepherd FA, et al. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol. 1999;17(2):658-667. [PubMed 10080612]
  132. Walter AW. Regarding "Intrathecal vincristine: 3 fatal cases and a review of the literature." J Pediatr Hematol Oncol. 2010;32(4):336-337. [PubMed 20445422]
  133. Walterhouse DO, Meza JL, Breneman JC, et al. Local control and outcome in children with localized vaginal rhabdomyosarcoma: a report from the Soft Tissue Sarcoma committee of the Children's Oncology Group. Pediatr Blood Cancer. 2011;57(1):76-83. [PubMed 21298768]
  134. Walterhouse DO, Pappo AS, Meza JL, et al. Shorter-duration therapy using vincristine, dactinomycin, and lower-dose cyclophosphamide with or without radiotherapy for patients with newly diagnosed low-risk rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group. J Clin Oncol. 2014;32(31):3547-3552. [PubMed 25267746]
  135. Wilson WH, Grossbard ML, Pittaluga S, et al, “Dose-Adjusted EPOCH Chemotherapy for Untreated Large B-Cell Lymphomas: A Pharmacodynamic Approach With High Efficacy,” Blood, 2002, 99(8):2685-93. [PubMed 11929754]
  136. Woods WG, O'Leary M, and Nesbit ME, “Life-Threatening Neuropathy and Hepatotoxicity in Infants During Induction Therapy for Acute Lymphoblastic Leukemia,” J Pediatr, 1981, 98(4):642-5. [PubMed 6937637]
  137. Woessmann W, Lisfeld J, Burkhardt B; NHL-BFM Study Group. Therapy in primary mediastinal B-cell lymphoma. N Engl J Med. 2013;369(3):282. [PubMed 23863060]
  138. World Health Organization, “Vincristine (and Other Vinca Alkaloids) Should Only Be Given Intravenously via a Minibag,” Alert 115, July 2007, World Health Organization, Geneva. Available at http://www.who.int/medicines/publications/drugalerts/Alert_115_vincristine.pdf
Topic 10045 Version 306.0