Orthostatic Hypotension During Vincristine Therapy

A patient with reticulum cell sarcoma developed severe orthostatic hypotension after one year of vincristine sulfate therapy. There was virtually no norepinephrine excretion; however, following withdrawal of vincristine therapy, norepinephrine excretion became normal in six weeks. There was some improvement in his hypotension, but the patient became very ill with an intracerebral tumor and died with brain stem metastasis. Decreased norepinephrine excretion was also present in two other patients who were studied while they were receiving vincristine.