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Two cases of suspected immunologic-based hypersensitivity reactions to etoposide therapy
1Department of Pharmacy Services, St. Vincent Medical Center, Toledo, OH 43608.
Objective:
To report two cases of suspected immunologic-based hypersensitivity reactions to etoposide therapy.
Data Synthesis:
Two cases are presented that differ from the majority of reported hypersensitivity reactions to etoposide. One patient, who tolerated etoposide during his first three-day chemotherapeutic dosage regimen, developed a hypersensitivity reaction to etoposide upon re-exposure to the drug during the first day of a subsequent three-day cycle. Another patient experienced a hypotensive episode on the first day of an initial three-day regimen, which did not recur on the two subsequent days of the cycle. However, when the patient was re-exposed to etoposide four weeks later, he experienced a severe reaction within minutes of drug infusion. Both patients were premedicated with corticosteroids and neither reported prior drug allergies.
Conclusions:
Based upon these cases and other literature reports, we believe these reactions primarily represent a type II or immunologic-based hypersensitivity reaction to etoposide.