Howell Grant, Oliai Caspian, Schiller Gary
Division of Hematology Oncology, David Geffen School of Medicine and University of California, Los Angeles, CA, U.S.A.
Anticancer Res. 2018 Dec;38(12):6927-6930. doi: 10.21873/anticanres.13070.
Liposomal formulation of anthracyclines provide better systemic and organ-specific tolerance, with potential for less local tissue damage during extravasation. Several small series have reported that most liposomal anthracycline extravasations are consistent with irritant injury without tissue necrosis. There have been no reports published regarding the clinical effects of extravasation of liposomal cytarabine-daunorubicin (CPX-351).
The patient received CPX-351 for relapsed acute myelogenous leukemia via a left chest wall port-a-catheter. The catheter became dislodged. Once symptoms developed, the infusion was discontinued, with observations demonstrating an 8-cm region of edema, warmth, no erythema, and no drainage. Limited supportive management was performed. Physical examination the following day demonstrated no evidence of necrosis, and erythema resolved completely without additional intervention.
CPX-351 extravasation behaving as an irritant is consistent with the reports of other liposomal anthracyclines.
蒽环类药物的脂质体制剂具有更好的全身耐受性和器官特异性耐受性，在外渗时对局部组织的损伤可能较小。几个小样本系列报道称，大多数脂质体蒽环类药物外渗与刺激性损伤相符，无组织坏死。关于脂质体阿糖胞苷-柔红霉素（CPX-351）外渗的临床影响尚无报道。
该患者因复发性急性髓系白血病通过左胸壁植入式静脉输液港接受CPX-351治疗。输液港发生移位。症状出现后，停止输注，观察发现有一个8厘米区域出现水肿、发热，无红斑，无渗液。进行了有限的支持性处理。次日体格检查未发现坏死迹象，红斑未经额外干预完全消退。
CPX-351外渗表现为刺激性，与其他脂质体蒽环类药物的报道一致。
