Extravasation GuideTissue injury risk of antineoplastic extravasation

Bleomycin

Bleomicina

Risk class Guidelines differ

  • Nonvesicantref. ESMO-EONS 2012
  • Irritantref. JSCN/JSMO/JASPO 2024

If it extravasates

Compress

  • Cold
References

Risk class: NonvesicantESMO-EONS 2012 (Table 1, p. vii167)

Risk class: IrritantJSCN/JSMO/JASPO 2024 (Table 2)

Compress: coldESMO-EONS 2012 (Fig. 1, p. vii170)

Not classified in: ONS/ASCO 2025

Details by guideline

Risk class in extravasation

Not classified in: ONS/ASCO 2025

Compress

  • ESMO-EONS 2012Cold compress
    "Local dry cold compresses"Non vesicant
    Figure 1, p. vii170
Brand names (ANVISA, Brazil) · DCB (Brazil)

DCB (Brazil)bleomicina (nº 1317)

Brand names (ANVISA, Brazil)BLESTO, BONAR

General recommendations of the guidelines

  • ONS/ASCO 2025Recommendation 1 · Strong; very low

    Use antidotes, when one exists, for vesicants and irritants with vesicant properties, rather than no antidote.

    Table 3, p. 388
  • ONS/ASCO 2025Recommendation 3 · Conditional; very low

    Thermal compress (cold or warm depending on the agent) rather than no compress.

    Table 3, p. 388
  • ONS/ASCO 2025Recommendation 4 · Conditional; very low

    Compress for more than 24 hours rather than 24 hours or less.

    Table 3, p. 388
  • ONS/ASCO 2025Recommendation 5 · Conditional; very low

    Central line extravasation: surgical referral or escalation of care in addition to conservative management.

    Table 3, p. 388
  • JSCN/JSMO/JASPO 2024CQ10a · Recommend (weak)

    Cold compression (weak recommendation).

    Table 1, CQ10a
  • JSCN/JSMO/JASPO 2024CQ10b · Not recommend (weak); D

    Non-use of warm compresses (weak recommendation).

    Table 1, CQ10b

Irritant antineoplastic drugs

CarboplatinCarmustineCisplatinCyclophosphamideDacarbazineDaunorubicin (liposomal)Doxorubicin (liposomal)EtoposideFluorouracilGemtuzumab ozogamicinIfosfamideIrinotecanIxabepiloneMelphalanMitoxantroneOxaliplatinStreptozocinTeniposideTopotecan

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