Adverse drug reactions during lymphatic mapping and sentinel lymph node biopsy for solid neoplasms

Area of Science:

• Oncology
• Immunology
• Radiology

Background:

• Lymphatic mapping (LM) utilizes isosulfan blue dye and technetium-99-labeled sulfur colloid (SC).
• Previous reports suggest a high incidence of adverse drug reactions (ADRs) during LM procedures.
• Solid neoplasms are frequently managed with LM, necessitating an understanding of associated risks.

Purpose of the Study:

• To determine the incidence of ADRs during LM for solid neoplasms.
• To identify potential risk factors associated with ADR development in patients undergoing LM.
• To evaluate the safety profile of LM agents, including isosulfan blue dye and SC.

Main Methods:

• Retrospective analysis of 753 patients undergoing LM between 1998 and 2004.
• LM performed using isosulfan blue dye alone or in combination with SC.
• Data collected on patient demographics, malignancy type, injection method, prior LM exposure, sulfa allergy history, and ADR occurrence.

Main Results:

• An overall ADR incidence of 1.1% was observed, with 0.1% experiencing anaphylaxis.
• No significant difference in ADR incidence was found between patients with and without sulfa allergies (3.4% vs 1%).
• No identifiable risk factors for ADR development were established; prior LM exposure did not increase ADR risk.

Conclusions:

• The incidence of ADRs during LM for solid neoplasms is low.
• Patients with sulfa allergies or prior LM exposure do not appear to have an increased risk of ADRs.
• Anaphylaxis is a rare but potential complication of LM that requires clinical vigilance.