Doxorubicin-induced hypersensitivity reactions

Area of Science:

• Oncology
• Pharmacology
• Immunology

Background:

• Anthracycline antibiotics, such as doxorubicin hydrochloride, are widely used in cancer chemotherapy.
• Allergic reactions are a known, though uncommon, side effect associated with anthracycline use.

Observation:

• Three patients receiving doxorubicin hydrochloride developed systemic hypersensitivity reactions.
• The reactions manifested as urticarial rash with pruritus, coinciding with drug initiation and confirmed by rechallenge.
• Reactions were managed with antihistamines and corticosteroids, and were not life-threatening.

Findings:

• Doxorubicin hydrochloride can induce systemic hypersensitivity reactions in susceptible patients.
• Diphenhydramine, or diphenhydramine and hydrocortisone, effectively treated the observed hypersensitivity.
• Discontinuation of doxorubicin was necessary in two patients due to the adverse reactions.

Implications:

• Awareness of potential hypersensitivity reactions to doxorubicin is crucial for oncologists and healthcare providers.
• Premedication strategies, including diphenhydramine, prednisone, and cimetidine, may mitigate reaction severity.
• Further research into the mechanisms and prevention of doxorubicin-induced hypersensitivity is warranted.