Vindesine in the treatment of leukaemia

Despite lack of cross-resistance with vincristine and a somewhat different toxicity spectrum, the semi-synthetic vinca alkaloid, vindesine, has not yet achieved its expected potential in the treatment of acute leukaemias. The ability of vindesine to induce remissions in vincristine-resistant and relapsed ALL is of particular interest for the development of potentially curative second-line regimens. Vindesine may also have a role in consolidation strategies for de novo ALL, although it will be difficult to demonstrate specific advantages for this agent as part of a multidrug treatment approach. In myeloid leukaemias, while vindesine appears to have a limited role in ANLL, it may be useful for the palliative treatment of CML blast crisis. In the future, new synergistic combinations, incorporating vindesine with for example, methotrexate or edatrexate, may be developed.