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Cytotoxic drug-induced fever: a report on procarbazine-induced hyperpyrexia

H Akyol1, F Sarialioğlu, M Büyükpamukçu

  • 1Division of Pediatric Oncology, Hacettepe Children's Hospital, Ankara, Turkey.

Medical and Pediatric Oncology
|January 1, 1990
PubMed

Insights

This case study highlights a rare instance of procarbazine-induced hyperpyrexia in a child undergoing chemotherapy for Hodgkin

Area of Science:

  • Pediatric Oncology
  • Clinical Pharmacology

Background:

  • Hodgkin's disease is a cancer of the lymphatic system.
  • Combined chemotherapy regimens, such as COPP, are standard treatment for Hodgkin's disease.
  • Adverse drug reactions can complicate cancer treatment, requiring careful monitoring.

Observation:

  • A child with Hodgkin's disease, neurofibromatosis, and pectus excavatum developed recurrent high fever during COPP chemotherapy.
  • Initial fever episodes were suspected to be infections, but recurred despite antibiotic treatment.
  • Hospitalization was required due to persistent hyperpyrexia and arrhythmia, prompting investigation into drug-induced fever.

Findings:

  • Procarbazine, a component of the COPP regimen, was identified as the causative agent for hyperpyrexia.
  • A test dose of procarbazine triggered a severe febrile reaction with nausea and vomiting.
  • This represents the second reported case of procarbazine-induced hyperpyrexia.

Implications:

  • Clinicians should consider cytotoxic-induced fever, specifically from procarbazine, in pediatric cancer patients presenting with unexplained hyperpyrexia.
  • Careful administration and monitoring of procarbazine are crucial, especially in patients with complex medical histories.
  • Prompt recognition and management with antihistamines and steroids can control procarbazine-induced febrile reactions.

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