Prevention and Management of Antineoplastic Extravasation Injury

Mullin, Shantel; Beckwith, M. Christina; Tyler, Linda S.

doi:10.1177/001857870003500105

Cited by 134 publications

(98 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To date, the management of anthracycline extravasations has included general unspecific recommendations such as stopping the infusion immediately and attempting to withdraw extravasated fluid from extravascular space [8], and additional specific measures such as the local application of ice packs and dimethyl sulfoxide (DMSO) [6,9]. Recently, dexrazoxane has been approved as an intravenous antidote for the management of anthracycline extravasation by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) [10,11].…”

Section: Introductionmentioning

confidence: 99%

Successful dexrazoxane treatment of a potentially severe extravasation of concentrated doxorubicin

Conde-Estévez¹,

Saumell

Salar

et al. 2010

Anti-Cancer Drugs

View full text Add to dashboard Cite

Dexrazoxane is now authorized for the treatment of anthracycline extravasations. Several clinical cases of doxorubicin extravasation treated with dexrazoxane have been reported to date, but detailed cases have not been published. We report a case of a successful dexrazoxane treatment for a potentially severe extravasation of concentrated doxorubicin. We also describe objective outcome of this treatment, drug tolerance to dexrazoxane and long follow-up. A 29-year-old man diagnosed with Hodgkin's lymphoma was prescribed a regimen including 90 mg of doxorubicin in a 50 ml infusion using a reduced occlusion infusion pump. After this infusion, the patient complained of pain around the site of injection and presented a 10x6-cm swollen area with erythema and inflammation. A significant portion of doxorubicin was extravasated. Dexrazoxane was prescribed as an antidote. Side effects of dexrazoxane were restricted to reversible hematological toxicity, nausea, and vomiting. The next day, the inflammation of the extravasation area was reduced. On day 7, a painless mild induration in the extravasated area was the only remaining sign of the extravasation. On day 40, an arm nuclear magnetic resonance image showed no focal injuries. At 6-month follow-up, the patient has no sequelae. The two risk factors that could have increased the severity of the extravasation are the use of an infusion pump and the high drug concentration. Dexrazoxane proved to be effective and moderately well tolerated. A dexrazoxane stock in oncological facilities could help to promptly handle emergencies like this. Anthracyclines can be administered using reduced occlusion infusion pumps, but it seems preferable to always administer a free-running infusion to minimize accidents like this one.

show abstract

Section: Introductionmentioning

confidence: 99%

Successful dexrazoxane treatment of a potentially severe extravasation of concentrated doxorubicin

Conde-Estévez¹,

Saumell

Salar

et al. 2010

Anti-Cancer Drugs

View full text Add to dashboard Cite

show abstract

“…[40][41][42][43][44] B. Breakthrough Nausea and Vomiting [34][35][36][37][38] : Patients should receive a prescription for an antiemetic to treat breakthrough nausea. One of the following regimens is recommended: 49 Hyaluronidase 150 units/1 mL injected intradermally at the extravasation site also has been recommended for treatment of vinca alkaloid extravasations. 49 …”

Section: A Acute and Delayed Emesis Prophylaxismentioning

confidence: 99%

“…One of the following regimens is recommended: 49 Hyaluronidase 150 units/1 mL injected intradermally at the extravasation site also has been recommended for treatment of vinca alkaloid extravasations. 49 …”

Section: A Acute and Delayed Emesis Prophylaxismentioning

confidence: 99%

Procarbazine, Lomustine, and Vincristine (PCV) Regimen for Central Nervous System Tumors

Solimando¹,

Waddell²

2017

Hosp Pharm

View full text Add to dashboard Cite

show abstract

“…Da Methotrexat auch ohne Komplikationen i.m. appliziert wird [29], scheint eine gewebsschädi-gende oder gar gewebsnekrotisierende Wirkung unwahrscheinlich. Ähnliches gilt für Bleomycin, das auch als "schwach reizend (nicht vesikant)" [12] "niedrige Nekrosewahrscheinlichkeit" [15,16] und "gewebsnekrotisierend" [21] charakterisiert wird.…”

Section: Hintergrundunclassified

“…Eine Polyneuropathie, z.B. bedingt durch Diabetes mellitus oder Vortherapie mit Vinca-Alkaloiden [28,29], organische oder arzneimittelbedingte eingeschränkte Wahrnehmungsfähigkeit [17,29] oder motorische Unruhe sollten beachtet werden.…”

Section: Patientenassoziierte Risikofaktorenunclassified

Paravasation von Zytostatika

Nogler-Semenitz¹,

Mader

Fürst-Weger

et al. 2004

Wien Klin Wochenschr

View full text Add to dashboard Cite

A variety of antineoplastic agents is associated with toxicity to healthy tissue and therefore represents a hazard for patients in case of extravasation. The most common risk factors include patient associated and iatrogenic risk factors. Due to the possible complications after extravasation, the knowledge of these risk factors is the basis for prevention, which is of utmost importance. A classification of antineoplastic agents according to the type of tissue damage includes the categories vesicant, irritant, and non-vesicant. Dependent on the extravasated agent, a series of emergency measures should be considered, preferably adhering to a standard operation procedure. There is good evidence for the successful use of antidotes to some antineoplastic agents. These antidotes are dimethylsulfoxide or hyaluronidase, often combined with topical measures such as cooling or application of heat. The application of sodium bicarbonate, sodium thiosulfate, and heparin is not recommended, whereas the usefulness of corticosteroids is still a matter of controversial discussions. Ambiguity in the management of extravasation is often a consequence of limited clinical evidence. Due to our deficient knowledge about some of the administered cytotoxics, there is ongoing need for action even after decades of therapy with antineoplastic agents.

show abstract

Prevention and Management of Antineoplastic Extravasation Injury

Cited by 134 publications

References 22 publications

Successful dexrazoxane treatment of a potentially severe extravasation of concentrated doxorubicin

Successful dexrazoxane treatment of a potentially severe extravasation of concentrated doxorubicin

Procarbazine, Lomustine, and Vincristine (PCV) Regimen for Central Nervous System Tumors

Paravasation von Zytostatika

Contact Info

Product

Resources

About