Drug fever after cancer chemotherapy is most commonly observed on posttreatment days 3 and 4

Ogawara, Daiki; Fukuda, Minoru; Ueno, Shiro; Ohue, Yoshihiro; Takemoto, Shinnosuke; Mizoguchi, Kosuke; Nakatomi, Katsumi; Nakamura, Yoichi; Obase, Yasushi; Honda, Takeshi; Tsukamoto, Kazuhiro; Ashizawa, Kazuto; Oka, M.; Kohno, Shigeru

doi:10.1007/s00520-015-2820-8

Cited by 15 publications

(10 citation statements)

References 17 publications

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“…Besides nausea, fever, vomiting, fatigue, headaches, and nasal congestion (14,36,48), clinical observations from our group show an increased rate of hypertension after finishing infusion of doxorubicin (DX) and CY and before discharge from the infusion unit. However, it is unclear whether elevation in blood pressure (BP) occurs during DX and CY administration.…”

Section: Introductionmentioning

confidence: 62%

Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer

Sales

Negrão

Testa

et al. 2019

American Journal of Physiology-Heart and Circulatory Physiology

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Purpose The purpose of the present study was to test the hypothesis that doxorubicin (DX) and cyclophosphamide (CY) adjuvant chemotherapy (CHT) acutely impairs neurovascular and hemodynamic responses in patients with breast cancer. Methods Sixteen women (age: 47.0±2.0 years; body mass index: 24.2±1.5 Kg.m−2) with stage II–III breast cancer and indication for adjuvant CHT underwent two experimental sessions, saline (SL) and CHT. In the CHT session, DX (60 mg/m2) and CY (600mg/m2) were administered in 45 min. In the SL session, a matching SL volume was infused in 45 min. Muscle sympathetic nerve activity (MSNA, microneurography), calf blood flow (CBF, plethysmography) and calf vascular conductance (CVC), heart rate (HR, electrocardiography) and beat‐to‐beat blood pressure (BP) (Finger plethysmography) were measured before, during and after each session. Blood samples (5 mL) were collected before and after both sessions for assessment of circulating endothelial microparticles (EMPs, flow cytometry), a surrogate marker for endothelial damage. Results MSNA and BP responses were increased (P<0.001), whereas CBF and CVC responses were decreased (P<0.001), during and after CHT session when compared to SL session. Interestingly, the vascular alterations were also observed at the molecular level through an increased EMPs response to CHT (P=0.03 vs. SL session). No difference in HR response was observed (p>0.05). Conclusions Adjuvant CHT with DX and CY in patients treated for breast cancer leads to acute sympathetic hyperactivity and endothelial alterations, which results in reduced muscle vascular conductance and elevated systemic BP. These responses may anticipate susceptibility to CHT‐induced longterm cardiovascular alterations. Support or Funding Information São Paulo Research Foundation ‐ FAPESP This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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Section: Introductionmentioning

confidence: 62%

Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer

Sales

Negrão

Testa

et al. 2019

American Journal of Physiology-Heart and Circulatory Physiology

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“…About 3-6% of adverse drug reactions only present with fever (48,49). Therefore, although in most cases, fever after chemotherapy is considered as an infection with neutropenia, drug fever should be viewed as an important cause (50). Interestingly, a study concluded that the febrile episodes appear on the third or fourth day after chemotherapy are typical adverse drug reactions of chemotherapy, rather than infection (50).…”

Section: Drug Fever After Chemotherapymentioning

confidence: 99%

“…Therefore, although in most cases, fever after chemotherapy is considered as an infection with neutropenia, drug fever should be viewed as an important cause (50). Interestingly, a study concluded that the febrile episodes appear on the third or fourth day after chemotherapy are typical adverse drug reactions of chemotherapy, rather than infection (50). Overall, the pathogenic examinations, the relationship between the drug administration with fever, and the time point of fever can help us accurately determine whether the fever after chemotherapy is a drug fever or a secondary infection including COIV-19.…”

Section: Drug Fever After Chemotherapymentioning

confidence: 99%

Challenges and countermeasures of thoracic oncology in the epidemic of COVID-19

Guo¹,

Chen²,

Su³

et al. 2020

Transl Lung Cancer Res

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a 2019 novel coronavirus disease infected by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province, and the epidemic situation has continued to spread globally. The epidemic spread of COVID-19 has brought great challenges to the clinical practice of thoracic oncology. Outpatient clinics need to strengthen the differential diagnosis of initial symptoms, pulmonary ground-glass opacity (GGO), consolidation, interstitial and/or interlobular septal thickening, and crazy paving appearance. In the routine of oncology, the differential diagnosis of adverse events from COVID-19 is also significant, including radiation pneumonitis, checkpoint inhibitor pneumonitis (CIP), neutropenic fever, and so on. During the epidemic, indications of transbronchial biopsy (TBB) and CT-guided percutaneous thoracic biopsy are strictly controlled. For patients who are planning to undergo biopsy operation, screening to exclude the possibility of COVID-19 should be carried out. For confirmed or suspected patients, three-level protection should be performed during the operation. Disinfection and isolation measures should be strictly carried out during the operation.At last, more attention to the protection of cancer patients and give priority to the treatment of infected cancer patients.

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“…However, due to chemotherapy or corticosteroid treatment administered to cancer patients, common signs of infections such as elevated neutrophil counts and fever may be absent [4]. To complicate matters, some cancer patients can develop a neoplastic or chemotherapy-induced fever of non-infectious etiology [5,6]. Such challenges in the early identification of BSI contribute to the delicate decision of whether to initiate antimicrobials among cancer patients, leading to underdetection of infection or over-treatment of non-infectious etiology.…”

Section: Introductionmentioning

confidence: 99%

Bloodstream Infections in Solid Tumor Malignancy: Risk Factors and Clinical Outcome

Ong¹,

Kumolosasi²,

Islahudin³

et al. 2021

Arch. Pharm. Pract

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Bloodstream infection (BSI) is a common complication in patients with solid tumor malignancies but available information on risk factors associated with BSI among these patients is scarce. To determine the associated risk factors and clinical outcomes of antibiotic treatment in BSI solid tumor malignancies. This was a retrospective case-control study performed in the National Care Centre. Adult patients with solid tumor malignancy and positive for blood culture bacteria growth (n=130) as well as adult patients with solid tumor malignancy and negative for blood culture bacteria growth were included (n=130). The most common form of solid malignancy (n=260) are those associated with digestive organs (n=72, 27.7%) and breast tumors (n=57, 21.9%). From 130 patients that were positive for BSI, gram-negative infection occurred in 71.5% (n=93) of the cases, mainly due to Klebsiella pneumoniae (n=31, 21.5%), Escherichia coli (n=24, 16.7%), and Pseudomonas aeruginosa (n=17, 11.8%). 98.2% (n=128) of BSI patients received empirical antimicrobial therapy while 58.5% (n=76) received adequate empirical antibiotic coverage. Elevated CRP levels (Adjusted OR=1.009; 95%CI=1.003-1.015; p=0.002) and total lymphocyte counts of <0.8x109/L (Adjusted OR=3.980; 95%CI=1.567-10.108; p=0.004) were found to be independent risk factors of BSI in solid tumor malignancy. There was no significant association between adequacy of empirical antibiotic coverage with the length of hospital stay (p=0.149), 48-hours all-cause mortality (p=0.255), and 28-days all-cause mortality (p=0.676). Close monitoring of the CRP elevation and presence of total lymphocyte counts <0.8x109/L may be used to determine the high risk for BSI in solid tumor malignancy patients.

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Drug fever after cancer chemotherapy is most commonly observed on posttreatment days 3 and 4

Abstract: Background: This study was undertaken to analyze the

Cited by 15 publications

References 17 publications

Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer

Chemotherapy acutely impairs neurovascular and hemodynamic responses in women with breast cancer

Challenges and countermeasures of thoracic oncology in the epidemic of COVID-19

Bloodstream Infections in Solid Tumor Malignancy: Risk Factors and Clinical Outcome

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