PACLITAXEL-ASSOCIATED HYPERSENSITIVITY REACTION DESPITE HIGH-DOSE STEROIDS AND PROLONGED INFUSIONS

The development of paclitaxel-containing chemotherapeutic regimens has been hindered by the frequent occurrence of allergic-type reactions t o the drug or its diluent. Fortunately, current pretreatment regimens are associated with a reduced risk of major hypersensitivity reactions . However, there is still a group of patients that may experience thes e reactions from Taxol despite the use of prechemotherapy steroids and antihistamines. In a recent report, patients with prior reactions to Taxol were successfully retreated utilizing 24 hr of high-dose steroid s and a very prolonged infusion regimen. We now report on two patients with major hypersensitivity reactions despite the use of this regimen . We conclude that not all Taxol-associated hypersensitivity reactions are preventable with current drug regimens. In addition, there is lit tle evidence to support continued or exclusive use of the suggested re challenge premedication schedule or the prolonged infusion rate. (C) 1 995 Academic Press, Inc.