Table 1 Hypersensitivity reactions after chemotherapy: classification and management
Classification of reactions | Management of reactions |
|---|---|
One or more mild symptoms: | Complete chemotherapy infusion with supervision at bedside. No treatment required. |
   • mild flushing |  |
   • rash |  |
   • pruritis |  |
One or more moderate symptoms: | Stop chemotherapy infusion, venous infusion of antihistamine (Clemastine 2 mg IV and Dexamethasone 10 mg IV), → after recovery of symptoms resume paclitaxel infusion at a rate of 20 ml/h for 15 minutes then 50 ml/h for 15 minutes then, if no further symptoms, at full dose rate until infusion is complete. |
   • moderate rash |  |
   • flushing |  |
   • mild dyspnea |  |
   • chest discomfort |  |
   • mild hypotension |  |
One or more severe symptoms: | Stop chemotherapy infusion, give IV antihistamine and steroid as above. Add epinephrine or bronchodilators if indicated, report as an adverse event, the patient will go off protocol therapy. |
   • respiratory distress requiring treatment |  |
   • generalized urticaria |  |
   • angioedema |  |
   • hypotension requiring therapy |  |