Inapparent infiltrations associated with vindesine administration

Vindesine is des-acetyl vinblastine amide sulfate (Eldisine, Eli Lilly and Co), an investigational derivative of the vinca alkaloid, vinblastine. Initial phase I results with vindesine have determined that myelotoxicity is dose-limiting and that, contrary to preclinical studies in animals [1], a neurotoxic potential is indeed present [2]. Another phase I study also observed a rather high incidence of phlebitis (16%) and of cellulitis (10%), however, myelosuppression remained the dose-limiting toxicity [3]. Because good clinical responses have been noted in lymphomas, leukemias [4] and some solid tumors including breast cancer [5], the drug has a potential for wide utility. However, while we have noted several clinical responses with vindesine, injections of the drug have been complicated by serious infiltration with atypically delayed presentation. The purpose of this communication is to briefly describe the incidence and course of these infiltrations.