Reply To: care patients receiving thiotepa

  • Irene Mendiola

    June 24, 2021 at 2:20 am

    Hi there. I’m a BMT nurse at Rady Children’s Hospital San Diego here in California. We have our patients on thiotepa bathe every 6 hours and for another 24 hours after the last dose of thiotepa. No soap, shampoo, lotion, cream or adhesive on the skin. Just plain water for bathing. We also check after each bath skin folds to make sure there’s no redness or irritation so we can intervene right away if ever there is before it gets worse. So far in my 15 years of experience, I haven’t seen a patient of ours have a moderate to severe skin reaction to thiotepa.

    We cover the site of the central line after each bath only with sterile gauze and wrap chest with sterile gauze/bandage (Kerlix Wrap). 24 hours after the last dose of thiotepa that’s when we stop the every 6 hour baths and then use the regular sterile dressing for the central line. 

    I hope this helps. All the best. 

    Irene Mendiola, BSN,RN, CPHON
    Temecula, CA
    United States
    Original Message:
    Sent: 06-23-2021 11:23 PM
    From: Wingsze Kong
    Subject: care patients receiving thiotepa

    hi all,

    We currently experienced a HSCT patient with severe skin burn reaction after 20 days of stem cell infusion. The doctors questioned the cause of the skin condition might caused by the thiotepa which gave in the conditioning protocol. Our institution only advice patients bath 2/ day for 24 hours after thiotepa, but do not have any guidelines or worksheet to follow. Therefore, I would like to ask is anyone willing to share their hospitals standards for caring patients receiving thiotepa? also I have some questions about caring patients receiving thiotepa:
    1. frequent bath for 24 hours or 48 hours after thiotepa?
    2. can use soap or just advise using warm water only ?
    3. frequency of changing central line dressing during receiving thiotepa? can still use transparent dressing like opsite dressing for covering the wound ? or only gauze is recommended?

    Thank you very much.

    Wing sze Kong
    Hong Kong Children’s Hospital