Phlogenzym(R) is safe and effective in reducing morbidity of vesicant chemotherapy extravasation. A prospective study

We prospectively evaluated the role of the oral proteolytic enzyme, Phlogenzym®, in hastening recovery from extravasation due to vinka alkaloid and/or anthracycline chemotherapy Patients with definitive extravasation due to vesicant chemotherapy were enrolled in the study Baseline characteristics were documented and the patients were started on one tablet of Phlogenzym® three times daily for a total of 1 month. Effects on swelling, pain, tenderness, redness, discoloration, ulceration and the patients' outcome were recorded. Patients whose features worsened were considered treatment failures and underwent plastic surgery Adverse effects were evaluated according to the World Health Organization's toxicity criteria. Of the 15 patients enrolled, one remains in the study and 14 are evaluable for efficacy Complete resolution was found in 10, partial response in two and progressive disease requiring reconstructive surgery in the remaining two. All responders recovered in a median of 13 days. In two patients, chemotherapy was delayed for 15 and 18 days, respectively. Toxicity of Phlogenzym® was mild and self-limiting. Phlogenzym® is safe and effective in recovery from vesicant chemotherapy extravasation and is useful even in patients with delayed presentation. The drug is easy to administer, cost effective and readily acceptable to patients. Twelve of the 14 patients showed no adverse effects while on the chemotherapy schedule.