Canterbury DHB
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A distinct clinical syndrome characterised by fever, maculopapular rash, and conjunctival suffusion has been described in children and adults receiving both high doses and low doses of cytarabine. However, the syndrome may have a more variable presentation with fever as the essential feature and arthralgia as one of the associated features. Confusion and nausea have also been reported. It occurs with administration of cytarabine alone as well as concomitant chemotherapy.
This reaction may occur immediately, or up to 12 hours following the cytarabine administration. It usually lasts 2 to 6 hours.
It has been postulated that this hypersensitivity reaction occurs more commonly in lymphoid malignancies. The data to support this is drawn from small numbers. A series of 6 patients with AML have been reported.
Administer 10 mg prednisone daily during cytarabine therapy if allergic symptoms develop. Should this not alleviate symptoms then administer 100 mg hydrocortisone as a premed before each cytarabine infusion/bolus.
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Topic Code: 5740
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