Amifostine‐Induced Fever: Case Report and Review of the Literature

Abstract

Amifostine, also known as WR-2721 (S-2-(3-aminopropylamino)-ethylphosphorothioic acid), is an organic thiophosphate cytoprotective agent used to reduce the frequency of severe xerostomia in patients with cancer undergoing postoperative radiation of the head and neck. A 56-year-old Caucasian man who received concomitant chemotherapy and radiation for head and neck cancer developed fever concurrent with the administration of amifostine. To our knowledge, this is the first case report that demonstrates the occurrence of fever with low-dose amifostine therapy without the manifestation of accompanying rash or hypotension. Patients receiving amifostine who develop only fever should be evaluated for an adverse drug reaction, as well as for sepsis and fevers of neutropenia, and it may be necessary to discontinue the drug. Recognition of amifostine as the cause of this adverse event may prevent the cost and inconvenience of a hospital admission.

Amifostine for salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer

“…The most common adverse e ects of amifostine are emesis, hypotension, somnolence, and sneezing (Boehme 2004;Bohuslavizki 1999b;Rades 2004). Less common side e ects include a metallic taste, flushing, malaise, hypocalcaemia, chills, and idiosyncratic reactions such as fever and rash (Boehme 2004;Rades 2004).…”

“…The most common adverse e ects of amifostine are emesis, hypotension, somnolence, and sneezing (Boehme 2004;Bohuslavizki 1999b;Rades 2004). Less common side e ects include a metallic taste, flushing, malaise, hypocalcaemia, chills, and idiosyncratic reactions such as fever and rash (Boehme 2004;Rades 2004). Consequently, careful inspections should be undertaken while intravenous administration of amifostine: First, blood pressure should be checked prior to the amifostine infusion and every minute during the infusion and up to 15 min a erwards.…”

Amifostine-induced back pain: A case report

“…5 The administration of amifostine significantly reduces the severity of xerostomia without compromising the efficacy of radiation therapy. [5][6][7][8][9] Common adverse effects of amifostine include hypotension, nausea, vomiting, and allergic reactions. Other side effects, such as flushing, chills, fever, hiccups, and sneezing, may occur during or after an infusion or administration of the drug.…”