Raylene M. Rospond, PharmD, BCPS
From the Department of Pharmacy Practice, Creighton University, School of Pharmacy and Allied Health Professions, Omaha, Nebraska.

Objective. To review the literature available on the use of Dimethyl sulfoxide (DMSO) to treat anthracycline extravasation.

Data Sources. English-language literature was gathered using Medline, EMBASE International Pharmaceutical Abstracts, CINAHL, and references from bibliographies.

Study Selection. Studies selected for review included controlled animal studies and any available human studies, including case reports and case series. All studies must have used DMSO in the treatment of an anthracycline extravasation.

Data Extraction. Data extracted from animal studies included the animal model used; method of doxorubicin and DMSO administration; ulcer outcome; and statistical significance. Individual case reports and case series were abstracted for the antineoplastic agent extravasated; associated symptoms; DMSO administration; concurrent therapies; and short- and long-term results (symptoms, functional damage)

Data Synthesis. One of six animal studies indicated a significant difference in peak lesion size and area under the curve between DMSO and control. However, local cooling resulted in less toxicity as compared with DMSO, and the time to ulcer healing was actually prolonged in the DMSO-treated group. Clinical experience with DMSO has resulted in no surgical intervention and no residual function impairment after anthracycline extravasation.

Conclusion. The controversial animal data and the lack of controlled clinical experience with DMSO should preclude its used as the sole initial therapy of anthracycline extravasations. A comparison study between topical DMSO and local cooling versus local cooling alone would aid in determining the true benefit of DMSO in the treatment of anthracycline extravasation.

Key Words. Dimethylsulfoxide, anthracycline, extravasation, doxorubicin.

J Oncol Pharm Practice, Vol 1, No 4, 1995