Wakamiya Nao, Suzuki Masanori, Isezaki Tatsuya, Funakoshi Ryohkan
Postgraduate Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, 296-8602, Japan.
Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Nakano-ku, Tokyo, Japan.
J Pharm Health Care Sci. 2025 Jun 12;11(1):48. doi: 10.1186/s40780-025-00446-1.
Dexrazoxane is used to treat extravascular leakage of anthracycline antitumor agents, but its own extravascular leakage and management remain underreported. This case aimed to highlight both doxorubicin and dexrazoxane leakage during treatment for diffuse large B-cell lymphoma.
A 55-year-old man with diffuse large B-cell lymphoma developed doxorubicin leakage during rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisolone (R-CHOP) therapy, which was treated with dexrazoxane. Subsequently, dexrazoxane leakage occurred, causing erythema and swelling. Topical clobetasol propionate was applied, leading to symptom resolution without necrosis. The patient successfully completed chemotherapy and achieved long-term remission.
This case report is one of the first to document the management of dexrazoxane extravascular leakage using topical steroids, effectively preventing severe outcomes. The findings suggest that topical steroids may be a desirable treatment approach for dexrazoxane leakage. Prompt intervention and interdisciplinary care contributed to the favorable outcome. This case highlights the need for further research and guideline refinement to optimize the management of inflammatory extravascular leakage.
右丙亚胺用于治疗蒽环类抗肿瘤药物的血管外渗漏，但其自身的血管外渗漏及处理情况仍鲜有报道。本病例旨在突出弥漫性大B细胞淋巴瘤治疗过程中阿霉素和右丙亚胺的渗漏情况。
一名55岁弥漫性大B细胞淋巴瘤男性患者在接受利妥昔单抗、环磷酰胺、盐酸阿霉素、长春新碱和泼尼松（R-CHOP）治疗时发生阿霉素渗漏，使用右丙亚胺进行治疗。随后，右丙亚胺发生渗漏，导致红斑和肿胀。局部应用丙酸氯倍他索，症状缓解，未发生坏死。患者成功完成化疗并实现长期缓解。
本病例报告是首批记录使用局部类固醇处理右丙亚胺血管外渗漏的病例之一，有效预防了严重后果。研究结果表明，局部类固醇可能是治疗右丙亚胺渗漏的理想方法。及时干预和多学科护理促成了良好结局。本病例突出了进一步研究和完善指南以优化炎症性血管外渗漏管理的必要性。
