Doxorubicin is an anthracycline antibiotic isolated from cultures of Streptomyces peucetius It is used in the treatment of hematological malignancies and solid and soft tissue tumors.
Pegylated liposomal doxorubicin may be less cardiotoxic than free doxorubicin but mucositis is increased.
Uncommon: urticaria 1/160 to 3%.
One death reported.
General: anaphylactic shock.
Cutaneous: pruritus, urticaria, rash, flush, flare reaction: erythema, pruritus, urticaria localized or adjacent to the site of infusion, hand-foot syndrome (palmar-plantar dysesthesia).
E.N.T.: nasal congestion.
Direct degranulation of mast cells or circulating basophils without antibody mediation.
Activation of alternate complement-activity pathway.
The use of pegylated liposomal doxorubicin (PLD) increases the frequency (7 to 9%) of hypersensitivity reactions in the first cycles of treatment (flushing, shortness of breath, facial swelling, headache, chills, back pain, tightness in the chest and throat, hypotension).
Concerning use of intravesical doxorubicin:
- if the reaction is severe; give an other effective intravesical agent
- if the reaction is mild and self-limiting; prophylactic administration of antihistamines may be useful.