Abstract
Skin necrosis is a recognized potential consequence of an inadvertent extravasation ofVinca alkaloids in the surrounding tissues during i.v. administration. Experimental studies suggest that hyaluronidase, an enzyme that degrades hyaluronic acid and improves the absorption of locally injected drugs, can reduce the risk of progressing to skin necrosis. On this basis, we used this enzyme as a local treatment after extravasations ofVinca alkaloids in seven patients. No patient suffered from subsequent skin necrosis. To the best of our knowledge, this is the first clinical report confirming the positive findings of experimental studies on the effectiveness of this antidote.
Key words: Extravasation of therapeutic material; Vincristine, toxic effects; Vinblastine, toxic effects; Vinorelbine, toxic effects; Hyaluronidase, therapeutic use
References
- Britton RC, Habif DV (1953). Clinical uses of hyaluronidase: a current review. Surgery 33:917–942 [PubMed] [Google Scholar]
- Depierre A, Lemarie E, Dabouis G, Samak R, Krikorian A, Besenval M (1988) Phase II study of navelbine (NVB) in non small cell lung cancer (NSCLC) (abstract). Proc Am Soc Clin Oncol 7:778 [Google Scholar]
- Dorr RT (1990) Antidotes to vescicant chemotherapy extravasations. Blood Rev 4:41–60 [DOI] [PubMed] [Google Scholar]
- Dorr RT, Alberts DS (1985)Vinca alkaloid skin toxicity: antidote and drug disposition studies in the mouse. J Natl Cancer Inst 74:113–120 [PubMed] [Google Scholar]
- Schneider SM, Distelhorst CW (1989) Chemotherapy-induced emergencies. Semin Oncol 16:572–578 [PubMed] [Google Scholar]