Dexrazoxane administration in 3 patients treated for anthracycline extravasation led to decreased antithrombin activity after a median of 4 days, with 1 patient developing deep-vein thrombosis.
Case Report (n=3)
Does dexrazoxane administration reduce antithrombin activity and increase the risk of thrombosis in patients receiving chemotherapy for hematological malignancies?
Dexrazoxane administration may be associated with decreased antithrombin activity and subsequent thrombosis, warranting clinical monitoring.
UNLABELLED: Dexrazoxane prevents anthracycline-induced cardiotoxicity and treats anthracycline extravasation. Although thrombosis is not a commonly observed adverse effect of dexrazoxane, a potential association has been suggested. We present three patients (four episodes) who experienced decreased antithrombin activity after dexrazoxane administration. All patients were prescribed dexrazoxane to protect soft tissues from anthracycline extravasation during chemotherapy for hematological malignancies. This led to a reduction in antithrombin activity after a median of 4 days from the first dexrazoxane injection. The activity levels recovered several days later, and one patient developed deep-vein thrombosis. There was no apparent explanation other than dexrazoxane use, raising the possibility that dexrazoxane may be associated with decreased antithrombin activity. We hypothesize that this decrease in antithrombin activity may contribute to thrombosis after dexrazoxane injection. Based on these cases and a review of previous reports on dexrazoxane and thrombosis, it is recommended that clinicians monitor antithrombin decline and thrombosis development in patients undergoing dexrazoxane treatment. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13691-026-00848-4.
Nagano et al. (Fri,) conducted a case report in Hematological malignancies with anthracycline extravasation (n=3). Dexrazoxane was evaluated on Decreased antithrombin activity and thrombosis. Dexrazoxane administration in 3 patients treated for anthracycline extravasation led to decreased antithrombin activity after a median of 4 days, with 1 patient developing deep-vein thrombosis.