Sublethal doses of vincristine (VNC) and bacterial lipopolysaccharide (LPS) administered simultaneously to adult male mice resulted in markedly enhanced mortality. All of 10 strains of Pseudomonas aeruginosa tested, 4 of 7 strains of Bacteroides, and 6 of 10 strains ofListeria monocytogenes were able to substitute for purified LPS Since Karp and Bradley (11) reported the enhanced toxicity of combinations of bacterial lipopolysaccharide (LPS) and the antitumor antibiotics pactamycin and sparsomycin, Rose and Bradley (22) and Marecki and Bradley (13) have demonstrated synergistic lethal interactions involving LPS and many cancer chemotherapeutic drugs, including vincristine (VNC) (23). Because many of the clinically useful antineoplastic agents possess the capability to interact in vivo with LPS and because debilitated patients and those receiving intense antitumor therapy display an increased susceptibility to bacterial infections (8), it is reasonable to propose that some of the adverse reactions associated with antitumor therapy are due to the interaction of LPS (i.e., bacterial endotoxin) and antineoplastic agents (2). It should be noted that VNC is widely used in the treatment of acute leukemia of childhood, in which the incidence of infection with gram-negative bacteria is very high (6). It is important, therefore, to characterize the synergistic toxicity involving LPS and VNC (23,24). An understanding of this adverse interaction could result in more effective utilization of VNC in cancer chemotherapy.The mechanism of the synergistic toxicity of LPS and VNC has not been studied directly. It has been established previously, however, that the route of administration of LPS and VNC did not influence overall mortality (13) but that simultaneous injection of LPS with VNC resulted in significantly greater lethality than administration either prior to or after drug (24). Moreover, the dose-effect curves for combinations of VNC and LPS were parallel to those for drug alone (23) and LPS alone (24), thereby indicating that no new toxic mechanism is involved and that the enhanced mortality results from mutual potentiation. Also, nonlethal doses of Pseudomonas aeruginosa cells were found to be able to substitute for purified LPS in the LPS-VNC synergy (24).In the present investigation, additional bacteria were tested for their ability to replace purified LPS in the LPS-VNC synergy. Moreover, the effects of LPS and VNC singly and in combination on a variety of host functions were determined. Data are presented to support the proposition that the combination of LPS and VNC causes a fatal renal failure, possibly as a consequence of intravascular coagulation.