Clinical

British Journal of Cancer (2004) 90, 304–305. doi:10.1038/sj.bjc.6601303 www.bjcancer.com
Published online 20 January 2004

Fatal outcome of a hypersensitivity reaction to paclitaxel: a critical review of premedication regimens

J S Kloover1, M A den Bakker2, H Gelderblom3 and J P van Meerbeeck4,5

  1. 1Department of Pulmonology, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands
  2. 2Department of Pathology, Josephine Nefkens Institute, Erasmus MC, Rotterdam, The Netherlands
  3. 3Department of Clinical Oncology, LUMC, Leiden, The Netherlands
  4. 4Department of Respiratory Diseases, University Hospital, Ghent, Belgium

Correspondence: JS Kloover, E-mail: jeroenkloover@tiscali.nl

5On behalf of The Rotterdam Oncologic Thoracic Study group, ROTS.

Received 28 February 2003; Accepted 23 July 2003.

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Abstract

Hypersensitivity reactions (HSRs) to paclitaxel are frequently encountered in patients receiving this antitumour drug. Administration of histamine H1- and H2-receptor antagonists and corticosteroids has been shown to reduce significantly the risk of developing an HSR in patients receiving taxanes. In this case report, we describe the fatal outcome of an HSR in a patient receiving paclitaxel despite short-course premedication. The level of evidence supporting the short-course i.v. premedication schedule is challenged, as it is not compatible with the pharmacokinetic properties of dexamethasone.

Keywords:

paclitaxel, hypersensitivity reaction, anaphylaxis, dexamethasone, premedication