ANTICANCER DRUG INDUCED INFUSION REACTIONS: A SINGLE INSTITUTE EXPERIENCE

Objective: To know the occurrence, onset and severity of infusion reactions associated with anticancer drug in an oncology hospital. Methods: For the patients who developed infusion reactions, causative drug, cycle of therapy, onset and duration of reaction, associated symptoms were recorded. The adverse drug reaction reporting form (yellow form) was used to report the infusion reaction. On the basis of reported and notified reaction, the severity of reactions was determined in accordance with NCI toxicity criteria, further assessed and evaluated for its causality and severity by using Naranjo’s causality assessment scale, Hartwig’s severity assessment scale. Results: During the study period 24 (0.18%) patients developed an infusion reaction to the anticancer therapeutic agents. Of these reactions, 33.32 % occurred during infusion of taxanes and monoclonal antibodies (MABs), 24.99% occurred during the use of platinum agents. In 54% patients, the infusion reactions occurred within the first hr of the infusion, 14 patients (58.33 %) developed a reaction in the first cycle of treatment. 79.16% ADRs were found to be possible, 12.5% reactions were definite and near about 8.33% were probable. Majority of the infusion reactions were grade 2 (50%) and grade 3 (46%). Rechallenge was generally discouraged in patients who have a severe initial reaction (grade 3 or 4). Conclusion: Although infusion reactions are rare, the incidence of mild to moderate reactions against taxanes and monoclonal antibodies is quite high. Clinical symptoms do not vary widely among the agents, though the onset time of symptoms does vary. Reactions against taxanes and monoclonal antibodies during the first exposure and in the following minutes suggest the activation of different mechanisms.