Gemcitabine-induced peripheral edema: Report on 15 cases and review of the literature Journal Article


Authors: Azzoli, C. G.; Miller, V. A.; Ng, K. K.; Krug, L. M.; Hensley, M. L.; O'Reilly, E. M.; Muller, R. J.; Kris, M. G.
Article Title: Gemcitabine-induced peripheral edema: Report on 15 cases and review of the literature
Abstract: Some degree of peripheral edema occurs in up to 20% of patients treated with gemcitabine (Gemzar). The edema is typically mild, requiring discontinuation of the drug in less than 1% of patients. Most patients require no therapy. However, in cases of peripheral edema, grade II or higher, suspension of gemcitabine and treatment with corticosteroids are often necessary, and permanent discontinuation of gemcitabine may be required on occasion. We have identified 15 cases of peripheral edema, grade II or greater, developing in patients receiving gemcitabine chemotherapy at Memorial Sloan-Kettering Cancer Center. The diagnosis was made based on temporal association with drug administration, and exclusion of other potential acute causes of edema including progression of disease and deep vein thrombosis. The 15 patients in this series represent less than 1% of all patients treated with gemcitabine at this institution over the same time period. Gemcitabine was immediately discontinued at the time of the onset of edema in 7 of the 15 patients due to severity of the symptoms. Thirteen of the 15 patients in this case series had experienced peripheral edema previously, and 6 had active low-grade edema at the time the gemcitabine was first administered. Patients receiving gemcitabine should be advised of this potential complication and urged to promptly report its development so that comorbid conditions can be excluded and proper supportive measures initiated. Patients predisposed to peripheral edema from some other cause may be at increased risk for developing severe peripheral edema with gemcitabine.
Keywords: adult; cancer chemotherapy; clinical article; treatment outcome; aged; middle aged; antibiotic agent; prednisone; disease course; cisplatin; gemcitabine; paclitaxel; pancreas cancer; methotrexate; treatment indication; carboplatin; edema; lung toxicity; breast cancer; antimetabolites, antineoplastic; lung non small cell cancer; differential diagnosis; dexamethasone; furosemide; deep vein thrombosis; bladder cancer; risk factor; vinblastine; time; self report; risk; docetaxel; pneumonia; lung metastasis; disease severity; comorbidity; peripheral edema; antihypertensive agent; vinca alkaloid; corticosteroid; toxicity; trastuzumab; navelbine; mitomycin; disease predisposition; deoxycytidine; gynecologic cancer; gallbladder cancer; hemolytic uremic syndrome; treatment withdrawal; diuretic agent; leg; case study; anticoagulant agent; cellulitis; humans; human; male; female; article; chemotherapygemcitabine
Journal Title: American Journal of Clinical Oncology
Volume: 26
Issue: 3
ISSN: 0277-3732
Publisher: Lippincott Williams & Wilkins  
Date Published: 2003-06-01
Start Page: 247
End Page: 251
Language: English
DOI: 10.1097/00000421-200306000-00007
PUBMED: 12796593
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Kenneth K Ng
    57 Ng
  2. Lee M Krug
    178 Krug
  3. Christopher G Azzoli
    111 Azzoli
  4. Vincent Miller
    270 Miller
  5. Martee L Hensley
    289 Hensley
  6. Eileen O'Reilly
    780 O'Reilly
  7. Mark Kris
    869 Kris
  8. Raymond J Muller
    24 Muller