Clinical features of the reaction:
(1) The reaction occurs during the first or second course of chemotherapy.
(2) The onset is within minutes of starting the infusion.
(3) The symptoms tend to be fairly characteristic, with dyspnea, throat and chest tightness, back pain, wheezing (bronchospasms), urticaria, erythematous rash and hypertension or hypotension.
(4) The symptoms tend to disappear quickly after the infusion stops.
Factors reducing the risk of a hypersensitivity reaction:
(1) use of Abraxane (paclitaxel formulated using albumin instead of Cremophor EL). Cremophor is polyoxyethylated castor oil, which is believed to be the main reason for hypersensitivity reactions.
(2) adequate premedication (antihistamines, other)
A person can usually be retreated with the drug once the hypersensitivity reactions have subsided. If the person was not pretreated then this should be done before attempting to reinitiate the therapy.
