Venous damage prevention by defibrotide in vinorelbine-treated patients.
OBJECTIVE
The aim of our study was to evaluate the incidence of venous toxicity induced by vinorelbine administration in patients who received a preventive therapy with defibrotide.


METHODS
From July 1996 to July 2002 we treated 203 patients with vinorelbine, 51 with vinorelbine alone and 152 with vinorelbine in combination with other drugs via peripheral vein infusion. Of the 203 patients, 123 were male and 80 female with a median age of 67 years (range 18 to 82 years), and 118 were chemotherapy-naive. Defibrotide was delivered i.v. at a dose of 400 mg in 250 ml normal saline. After infusion of 125 ml over about 15 min, vinorelbine mixed with 10 ml normal saline was delivered as quick brief repeated pulses over 5 min through the plastic tube, followed by infusion of the remaining defibrotide. The specific Rittenberg scale was used to assess venous irritation episodes.


RESULTS
Among a total of 1336 vinorelbine infusions, with a median of five infusions per patient, the incidence of venous irritation episodes graded according to Rittenberg scale was 1.1% (15), of which 0.6% (8) were grade 2 and 0.5% (7) grade 1. Globally, 15 patients (7.3%) developed venous toxicity after a median of 3 infusions (range 1-14), but no patient had more than one event.


CONCLUSIONS
Our findings support the use of defibrotide as an effective, safe and low-cost means for preventing vinorelbine-related venous damage.
Unità Operativa di Oncologia Medica, Azienda Ospedaliera Universitaria G. Martino, Via Consolare Valeria, 98125 Messina, Italy.
M
M
Mare
R
R
Maisano
N
N
Caristi
V
V
Adamo
G
G
Altavilla
R
R
Carboni
S
S
Munaò
F
F
La Torre
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use*; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000139:chemically induced / Q000517:prevention & control*; D014680:Veins / Q000187:drug effects*; D014747:Vinblastine / Q000009:adverse effects* / Q000031:analogs & derivatives*; D000077235:Vinorelbine
D000972:Antineoplastic Agents, Phytogenic; D010975:Platelet Aggregation Inhibitors; D011089:Polydeoxyribonucleotides; C036901:defibrotide; D014747:Vinblastine; D000077235:Vinorelbine