Risks and mitigation strategies to prevent etoposide infusion-related reactions in children

Pharmacotherapy. 2021 Aug;41(8):700-706. doi: 10.1002/phar.2603. Epub 2021 Jun 29.

Abstract

Etoposide is an antineoplastic agent widely used for treatment of many pediatric cancers. Etoposide has been associated with infusion-related reactions. In this brief report, we compare etoposide infusion-related reactions that occurred over a 10-year period at two freestanding pediatric hospitals. Infusion reactions occurred in 1% of patients at two hospitals across the study period. Rates of 4.8%, 3.4%, and 7.9% were observed at Children's Mercy Hospital during 2018, 2019, and 2020, respectively, after the implementation of in-line filters during etoposide infusions in late 2017. Of the 32 patients who experienced adverse reactions, 41% were rechallenged after the reaction and all were able to tolerate at least one future dose with either pre-treatment or extending infusion duration. This work highlights the importance of a multicenter approach to investigating adverse drug reactions (ADRs) as variation in practice can provide key information about ADRs and potential risk factors.

Keywords: child; drug hypersensitivity; drug-related side effects and adverse reactions.

Publication types

  • Multicenter Study

MeSH terms

  • Antineoplastic Agents* / administration & dosage
  • Antineoplastic Agents* / adverse effects
  • Child
  • Drug-Related Side Effects and Adverse Reactions* / prevention & control
  • Etoposide* / administration & dosage
  • Etoposide* / adverse effects
  • Humans
  • Infusions, Intravenous / adverse effects
  • Neoplasms* / drug therapy
  • Risk Factors

Substances

  • Antineoplastic Agents
  • Etoposide