Predisposition and prevention

Antineoplastic extravasation management: Consensus of the Spanish Oncology Pharmacy Group (GEDEFO)

“…The group doesn't recommend dexrazoxane use with liposomal anthracyclines, because are classified as less tissue-damage risk and the limited evidence available. 1,12…”

“…Few cases have been published dealing with “mixed” (binary or ternary mixture) or during “Y” site administration extravasation and when extravasation identification is delayed. 1 In case of extravasation by more than one vesicant agent is suspected, there is little information about the best strategy to follow. Comas and Mateu described the sequential use of hyaluronidase and DMSO, without applying any physical measures, after extravasation with vincristine and doxorubicin “Y” site administration (VAD regimen) by a peripherally access, with good outcome.…”

“…Antineoplastic extravasation is the inadvertent unintentional instillation or leakage of these agents into the perivascular and subcutaneous spaces during their administration. 1 Extravasation is considered an oncology emergency, as can be associated with drug-induced tissue damage that can result in severe iatrogenic consequences for patients, such as tissue necrosis. 2,3 Extravasation can also compromise oncology patient´s health outcomes and quality of life, 1,4 due to treatment delays and tissue damage complications.…”

“…There is little or no information of extravasation management in summaries of product characteristics, labels, or prescribing information sheets of the new antineoplastic introduced in clinical practice. 1,11 In addition, some of the principal variables, such as, extravasated volume, concentration or time remaining in tissue, are not always detailed in papers to assess the potential risk of tissue-damage and the effectiveness of the implemented strategies. All these factors unable to ascertain the optimal extravasation management.…”

“…1 Extravasation is considered an oncology emergency, as can be associated with drug-induced tissue damage that can result in severe iatrogenic consequences for patients, such as tissue necrosis. 2,3 Extravasation can also compromise oncology patient´s health outcomes and quality of life, 1,4 due to treatment delays and tissue damage complications. The incidence of extravasations reported in the literature is between 0.1% and 6.0% in peripheral venous lines and 0.26% to 4.7% in central venous lines.…”