Acute infusion-related reactions in pediatric patients receiving etoposide at a tertiary cancer center

J Oncol Pharm Pract. 2024 Jan;30(1):197-200. doi: 10.1177/10781552231215087. Epub 2023 Nov 13.

Abstract

Introduction: Etoposide is a key component of many pediatric chemotherapy regimens for both hematologic and solid tumors. It is well documented that patients receiving etoposide may experience infusion-related reactions.

Methods: In this study, total doses of etoposide and etoposide phosphate were identified, and infusion-related reactions were retrospectively evaluated at a large pediatric oncology ambulatory clinic. The primary outcome was to determine the rate of acute infusion-related reactions to etoposide. A secondary objective was to identify potential risk factors associated with such reactions.

Results: Overall, 1463 doses of etoposide were dispensed to 150 unique patients and 15 patients (10%) experienced etoposide infusion-related reactions. Of the 15 patients that experienced etoposide infusion-related reaction, two were successfully able to tolerate subsequent infusions with a slower etoposide infusion rate and pre-medications. The remaining patients changed drug formulation to etoposide phosphate (n = 12) or continued therapy without any formulation of etoposide (n = 1). Patients with classical Hodgkin's lymphoma experienced a higher incidence of infusion-related reactions compared to the overall patient population (30.5% vs. 10%) and made up 73.3% of all infusion-related reactions during the study period.

Conclusions: During the examined study period, 10% of patients experienced an acute infusion-related reaction to etoposide. This review builds on previous literature concluding that additional monitoring may be warranted in patients with classical Hodgkin's lymphoma receiving etoposide.

Keywords: Etoposide; pediatric; reaction; risk factors.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Child
  • Drug-Related Side Effects and Adverse Reactions* / etiology
  • Etoposide / adverse effects
  • Hodgkin Disease* / drug therapy
  • Humans
  • Organophosphorus Compounds
  • Retrospective Studies

Substances

  • etoposide phosphate
  • Etoposide
  • Organophosphorus Compounds