An oncology journal has retracted a 2014 paper that contained a potentially fatal mistake.
Specifically, the paper suggested that a chemotherapy drug be injected intrathecally — i.e., in the spine. But according to the retraction notice, the medical literature has unequivocally shown that that form of treatment is “uniformly fatal.”
The retraction comes approximately 18 months after the journal published a letter to the editor alerting readers to the risky wording in the 2014 paper.
Here’s the notice, issued by Hematological Oncology:
The above article, published online on 19 December 2014 in Wiley Online Library (wileyonlinelibrary.com), and in volume 34, issue 1 (March 2016), has been withdrawn by agreement between the Journal Editor in Chief, Francesco Bertoni, and John Wiley & Sons Ltd. The retraction has been agreed due to serious scientific errors which could constitute a health hazard if left intact. On page 5 it is stated, “Commonly used IT chemotherapy agents include methotrexate, cytarabine, and dexamethasone with less often being vincristine and thiotepa”, while in Table 4 vincristine is listed as an option for intrathecal agents.
Vincristine administered intrathecally is uniformly fatal, as is well documented in the medical literature.
“Overview of recent trends in diagnosis and management of leptomeningeal multiple myeloma” has been cited three times since it was published online in December, 2014, according to Clarivate Analytics’ Web of Science, formerly part of Thomson Reuters.
Months after the paper appeared, in July 2015 the journal published a letter alerting readers to the article’s problems:
…we disagree with that the apparent recommendation for IT vincristine in both the text and Table 4, given that vincristine is a severe neurotoxin when administered IT. Several case reports of accidental IT vincristine administration describe rapid ascending myeloencephalopathy that generally results in respiratory failure and death. In a few cases, emergent neurosurgical intervention such as cerebrospinal fluid lavage have been pursued immediately, and patients were able to avoid a fatal outcome though they suffered significant neurological deficits. In fact, there have been many recommendations made in literature and measures taken to help reduce the incidence of IT vincristine administration, which generally occurs accidentally when it occurs.
The authors of the letter note that vincristine carries a black box warning against administering it intrathecally, and asks the authors to remove the “potentially hazardous recommendation” from an “otherwise highly informative manuscript.”
Apparently, the journal decided to remove the entire thing. We’ve contacted editor Francesco Bertoni at the Institute of Oncology Research in Switzerland and the first author of the retracted paper, Mahender R. Yellu, listed at the University of Cincinnati in Ohio, to find out more.
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Horrifying! So much for peer reviewed articles! Why should we trust one single article any longer on research or even procedures if ones that are “uniformly fatal” are left intact for two years? THANK YOU for this post.
Surely a correction would have been more appropriate given that the authors of the letter asks the authors to remove the “potentially hazardous recommendation” from an “otherwise highly informative manuscript”.
What happened here is a serious error. Simple retraction is not enough. A serious error in an hospital environment immediately triggers an investigation in the causes. This should happen here as well. For consideration: competence of authors and peer reviewers; research culture of the institute involved; the role of the editors; the role of the publisher etc. The next question is how to reduce the probability of these errors to recur.