More About Antimitotic Therapy
Antimitotic Therapies utilize a variety of drugs that are designed to block cell growth by stopping cell division (mitosis). They are commonly used to treat cancer, but have been used in an effort to limit the growth and development of the HPV Virus and Warts. The most commonly used form of Antimitotic agent for the treatment of warts is Bleomycin with Retinoids and Podophyllin being more seldomly used. The focus below will be on Bleomycin, a cytotoxic polypeptide that inhibits DNA synthesis, causes tissue death and may initiate an immune response, however this hasn’t been proven.
How does this treatment work?
Bleomycin is injected intradermally; delivery techniques do vary with some using a standard needle, some using a bifurcated needle while others drop the bleomycin onto the wart and then pierce the wart with the needle. DNA and protein synthesis are inhibited, and cell death is triggered. Tissue death may then initiate an immune response, but this is yet to be proven.
How effective is this treatment?
Similar to other modalities, the clearance rates range significantly making it’s effectiveness difficult to measure.
What can patients expect when receiving this treatment?
Typical Treatment Protocol:
- Local nerve block commonly administered prior to injection
- Bleomycin comes in 15-unit vials; it is typically is diluted with 30 mL of saline
- 0.3 mL (0.15 units) are typically injected intradermally
- Additional injections commonly delivered ever 3-4 weeks until clearance is achieved
- Considered a limiting factor for the treatment
- Nerve blocks often necessary in order to tolerate
- Mobility limitations based on the location of the injection
- No home care required until next injection
- Injection pain and burning
- Swelling and pain within 24 to 72 hours after injection.
- Blood blister is common.
- Raynaud’s phenomenon is a definite concern in treated digits, and the nail may be lost.
- May also cause lymphangitis and hyperpigmentation.
Note: Bleomycin treatment of warts results in significant systemic drug exposure and should not be used on pregnant women, children, immunosuppressed patients or patients with vascular disease
Where can I receive this treatment?
As a less commonly used treatment option, not all clinicians will have the option or will elect to treat with antimitotic therapy. If you would like to be treated with bleomycin or other antimitotic agents, you should call ahead to assess availability, however consultation is recommended prior to confirming an appropriate treatment.