At NCCN, our mission to improve the lives of patients with cancer is at the core of everything we do and ensuring patient safety is of utmost importance.
That's why we have launched the NCCN Just Bag It Campaign for the safe handling of vincristine, calling for health care professionals to always dilute vincristine in a 50ml mini-IV drip bag and never in a syringe.
View the November 10 Press Conference
Why Bag It?
Vincristine is an important chemotherapeutic agent used primarily in the treatment of patients with leukemia and lymphoma. When it enters the blood, it is highly effective at blocking the growth of cancer by preventing cells from separating. However, vincristine is a neurotoxin that causes peripheral neuropathy when given intravenously and which causes profound neurotoxicity if given into the spinal fluid, which flows around the spinal cord and brain.
Many patients who receive vincristine have a treatment regimen that includes other chemotherapy drugs that are administered intrathecally, or injected into the spinal fluid with a syringe. If vincristine is mistakenly administered into the spine, it is uniformly fatal, causing ascending paralysis, neurological defects, and eventually death.
To ensure that vincristine is always administered properly, NCCN’s Best Practices Committee, which is dedicated to improving cancer treatment protocols, has issued guidelines advising health care providers to always dilute vincristine in a mini IV-drip bag and never use a syringe. This precaution renders it impossible to accidentally administer the medication into the spine and greatly decreases the chances of improper dosage.
Vincristine Prepared in IV Drip Bag (RECOMMENDED)
Vincristine Prepared in Syringe (NOT RECOMMENDED)
Christopher Robin Wibeto, the third of four children, a lover of movies, computer games and progressive rock music, passed away August 29, 2005 in Stanford, California at the age of 21 following a tragic medical error involving the mishandling of the chemotherapy agent, vincristine.
Christopher had been hospitalized for about a month with Non-Hodgkins Lymphoma, but was making progress as the treatments went on. He and his mother had discussed traveling to Florida and Georgia to visit his siblings when he felt better. He was also considering going back to school.
But one day, Christopher mistakenly received an injection of the chemotherapy agent vincristine into his spinal fluid. Widely used in patients with Leukemia or Lymphoma, vincristine should only be administered directly into a patient’s vein. When it enters the blood, it is highly effective at blocking the growth of cancer by preventing cells from separating. However, vincristine is a neurotoxin, and if delivered into the spinal fluid, causes paralysis and death, usually within days.
Medical oncologist Robert W. Carlson, MD cared for Christopher at another hospital following the mistake and watched, distraught, as Christopher’s condition deteriorated and nothing could be done to reverse it. He died within four days. When Dr. Carlson became CEO of the National Comprehensive Cancer Network (NCCN) in 2013, he vowed to take action to prevent future errors.
NCCN’s 27 member institutions create the cancer treatment guidelines that set the standard for care in the US and around the world. Dr. Carlson worked with NCCN’s Best Practices Committee to issue guidelines advising health care providers to always dilute and administer vincristine in a mini IV-drip bag and never use a syringe to administer the medication. This precaution renders it impossible to accidentally administer the medication into the spinal fluid and greatly decreases the chances of improper dosage.
Today, all NCCN member institutions have adopted the safety practice, and on November 10, 2016, Christopher’s parents, Robin and Debra Wibeto, joined NCCN to launch a national campaign: Just Bag It: The NCCN Campaign for Safe Vincristine Handling. The effort calls for all cancer treatment providers in the US and abroad to adopt the NCCN recommended guidelines to eliminate the possibility of this tragic medical error once and for all.
"We are proud and honored to be part of this campaign," Debra Wibeto said. "If it saves even one life, Christopher’s death will have made a difference."