The prevention and treatment of immediate hypersensitivity reactions from cancer chemotherapy.

Abstract

I N THE PRESENT-DAY PRACTICE of medical oncology, administration of chemotherapeutic drugs is one of the primary responsibilities of oncology nurses. These specialists are welleducated in the appropriate management of the common adverse side effects of chemotherapeutic agents, including nausea, vomiting, and bone marrow suppression. However, until recently, the importance of hypersensitivity reactions, an often serious complication of chemotherapy administration, has received little attention. Since these potentially life-threatening reactions occur immediately after drug administration-a time when frequently only nursing personnel are available-oncology nurses should be well-informed in the recognition and treatment of immediate hypersensitivity reactions resulting from cancer chemotherapy. Hypersensitivity reactions to drugs are the result of a reaction between antibodies and a foreign antigen, in this case, the chemotherapy drug. These reactions are divided into four classes-types I, II, III, and IV-based upon the mechanism by which the drug results in tissue damage (Table l).’ Type I, immediate hypersensitivity reactions (anaphylactic, anaphylactoid), will be the focus of this article. Anaphyluxis is a generic term used to describe the clinical manifestations of any type I reaction.