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Barry R. Miller, MD
Brown University Rhode Island Hospital Providence

JAMA. 1985;253(14):2045.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I found the recent article by Hogan-Dann et al¹ interesting. I think caution is due when patients with malignant neoplasms who have or have had a serious neurological disease are considered for treatment with a vinca alkaloid.

I had the experience of treating a 51-year-old woman with adjuvant chemotherapy for stage II breast cancer following modified radical mastectomy. As a child aged 12 years, she had developed poliomyelitis, from which she became tetraparetic. She recovered completely by age 18 years. However, when the first dose of intravenous vincristine sulfate (1.5 mg) was administered 39 years later, she developed a severe neurotoxic reaction by the following day. She complained of bilateral ear and jaw pain, aching gums, severe constipation, dysphagia, generalized weakness, and severe dysesthesias in the fingers and toes. She became tetraparetic again, having difficulty getting out of bed and a chair. These symptoms persisted for . . . [Full Text PDF of this Article]

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