HEADACHE, CIRCUMORAL PARESTHESIA, AND FACIAL FLUSHING ASSOCIATED WITHHIGH-DOSE CARMUSTINE INFUSION

We describe seven patients who developed symptoms including severe hea dache, circumoral paresthesia, and facial flushing during high-dose ca rmustine (BCNU) infusion as part of the preparative regimen for autolo gous peripheral blood stem cell (PBSC) transplantation for metastatic breast cancer, Five patients responded to pain medications, including partial and complete opiate receptor agonists, Premedication of subseq uent doses of BCNU with corticosteroids, pain medications, or benzodia zepines lessened, but did not prevent the same symptoms from recurring , The incidence and mechanism of this toxicity are unknown, but this a dverse syndrome should be considered when administering high-dose BCNU infusions.