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January 31, 1977, Vol 237, No. 5 >
ARTICLE | January 31, 1977

Possible Anaphylactic Reaction to Intravenous Cyclophosphamide: Title and subTitle BreakReport of a Case FREE

Richard K. Karchmer, MD; Vincent L. Hansen, MD
[+] Author Affiliations

Reprint requests to Division of Hematology-Oncology, Department of Internal Medicine, University of Utah Medical Center, Salt Lake City, UT 84132 (Harmon J. Eyre, MD).


JAMA. 1977;237(5):475-475. doi:10.1001/jama.1977.03270320053025
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THE COMMON side effects and toxicity of cyclophosphamide include nausea, vomiting, immunosuppression, myelosuppression, sterility, and hemorrhagic cystitis.1 Rarer toxic reactions include the inappropriate secretion of antidiuretic hormone.1 We have recently observed a patient who had a hypotensive episode and respiratory arrest immediately following an intravenous injection of cyclophosphamide.

Report of a Case  A 66-year-old woman experienced headaches, cervical adenopathy, and bilateral papilledema in September 1971. At surgery, she was found to have a poorly differentiated lymphocytic lymphoma invading the membranous tissue, dura, and bone of the skull. Postoperatively, she received radiation therapy to the skull and the cervical and supraclavicular lymph nodes.The patient was then referred to the University of Utah Medical Center in May 1972. Although her physical examination and bone marrow biopsy specimen showed no evidence of lymphoma, a bipedal lymphangiogram was positive. In June 1972, intermittent chemotherapy was begun. Each course consisted of cyclophosphamide,

REFERENCES

1 +
Gershwin ME, Goetzl EJ, Steinberg AD:  Cyclophosphamide: Use in practice . Ann Intern Med 80:531-540, 1974;.
2 +
Tashima CK:  Immediate cerebral symptoms during rapid intravenous administration of cyclophosphamide (NSC-26271) . Cancer Chemother Rep 59:441-442, 1975;.
3 +
Arena PJ:  Oropharyngeal sensation associated with rapid intravenous administration of cyclophosphamide (NSC-26271) . Cancer Chemother Rep 56:779-780, 1972;.
4 +
Bagley CM, Bostick FW, DeVita VT:  Clinical pharmacology of cyclophosphamide . Cancer Res 33:226-233, 1973;.
5 +
Brauer MJ, McEvoy BF, Mitus WJ:  Hypersensitivity to nitrogen mustards in the form of erythema multiforme: A unique adverse reaction . Arch Intern Med 120:499-503, 1967;.

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1 +
Gershwin ME, Goetzl EJ, Steinberg AD:  Cyclophosphamide: Use in practice . Ann Intern Med 80:531-540, 1974;.
2 +
Tashima CK:  Immediate cerebral symptoms during rapid intravenous administration of cyclophosphamide (NSC-26271) . Cancer Chemother Rep 59:441-442, 1975;.
3 +
Arena PJ:  Oropharyngeal sensation associated with rapid intravenous administration of cyclophosphamide (NSC-26271) . Cancer Chemother Rep 56:779-780, 1972;.
4 +
Bagley CM, Bostick FW, DeVita VT:  Clinical pharmacology of cyclophosphamide . Cancer Res 33:226-233, 1973;.
5 +
Brauer MJ, McEvoy BF, Mitus WJ:  Hypersensitivity to nitrogen mustards in the form of erythema multiforme: A unique adverse reaction . Arch Intern Med 120:499-503, 1967;.

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