Successful Management of Vinblastin Overdose with Exchange Transfusion: A Case Report

Accidental overdose of chemotherapy drugs including vinblastin (VBL) have been reported in the literature. As VBL overdose is potentially fatal, we decided to introduce a 2-year-old girl affected by langerhans’ cell histiocytosis who was accidentally injected 10-times the prescribed dose of VBL (16 mg), and was saved with whole blood double exchange transfusion at 8 and 20 hrs after the accidental injection. The earliest manifestations were irritability and sinus tachycardia which alleviated after starting digoxin and at the end of the 2nd exchange transfusion. Other reported adverse effects were myelosuppression, weakness of extremities, diminished deep tendon reflexes and ileus which resolved at the time of discharge from hospital on day 13 of admission. It is speculated that exchange transfusion is an effective modality in reducing the serious adverse effects of VBL overdose.