IFOSFAMIDE EXTRAVASATION

OBJECTIVE: To report a case in which a local reaction is attributed to an ifosfamide extravasation. Previously, extravasated ifosfamide has been considered a nonirritant. CASE SUMMARY: A 54-year-old woman with a non-Hodgkin's lymphoma in stage IV B developed a local reaction in h er right arm after an ifosfamide extravasation. No pressure was prescr ibed, no bandaging was applied on the affected area, and the limb was elevated to the heart level. In addition, chondroitinsulfatase 150 tur bidity-reducing units was administered subcutaneously around the area. This procedure was repeated 12 hours later, resulting in a satisfacto ry decrease in the inflammatory signs and pain. DISCUSSION: The local reaction in the patient's arm cannot be attributed to the hypertonicit y of the infusing solution or to the vehicle of the infusate. The anti dote used was chondroitinsulfatase, an enzyme similar to hyaluronidase . It enhances the systemic uptake of the drug from the tissue. CONCLUS IONS: Extravasated ifosafamide is a potential irritant. General measur es applied after its extravasation can be potentiated strongly by loca l subcutaneous administration of chondroitinsulfatase or hyaluronidase , repeated if necessary.