Delayed presentation of vincristine extravasation.

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Vincristine is a vesicant chemotherapy agent that can cause extravasation, leading to tissue necrosis and oncological emergencies.
• Extravasation occurs when chemotherapy leaks from the intended vessel into surrounding perivascular tissue.

Observation:

• A 29-year-old woman with B-cell acute lymphoblastic leukemia (ALL) on maintenance chemotherapy (POMP regimen) developed symptoms 48 hours after intravenous vincristine administration.
• Symptoms included burning, pain, and tenderness at the injection site, progressing to a large brown lesion within 7 days.

Findings:

• The patient was treated with betamethasone cream, dimethyl sulfoxide (DMSO) solution, and oral levofloxacin.
• Complete lesion improvement was observed within 10 days of initiating this therapy, with no significant adverse events.

Implications:

• This clinical approach demonstrated a beneficial effect in managing delayed vincristine extravasation.
• The findings suggest this treatment strategy could be considered for similar cases, especially when standard antidote therapies are ineffective.