title: Headache, circumoral paresthesia, and facial flushing associated with high-dose carmustine infusion.
abstract: We describe seven patients who developed symptoms including severe headache, circumoral paresthesia, and facial flushing during high-dose carmustine (BCNU) infusion as part of the preparative regimen for autologous peripheral blood stem cell (PBSC) transplantation for metastatic breast cancer. Five patients responded to pain medications, including partial and complete opiate receptor agonists. Premedication of subsequent doses of BCNU with corticosteroids, pain medications, or benzodiazepines lessened, but did not prevent the same symptoms from recurring. The incidence and mechanism of this toxicity are unknown, but this adverse syndrome should be considered when administering high-dose BCNU infusions.
authors.affiliation: Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston 77030, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Woo
authors.forename: C
authors.initials: C
authors.lastname: Ippoliti
authors.forename: J
authors.initials: J
authors.lastname: Bruton
authors.forename: R
authors.initials: R
authors.lastname: Mehra
authors.forename: R
authors.initials: R
authors.lastname: Champlin
authors.forename: D
authors.initials: D
authors.lastname: Przepiorka
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000556:secondary / Q000628:therapy; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects*; D016207:Cytokines / Q000378:metabolism; D005145:Face; D005260:Female; D005483:Flushing / Q000139:chemically induced*; D006261:Headache / Q000139:chemically induced*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D004091:Hydromorphone / Q000008:administration & dosage; D008875:Middle Aged; D009055:Mouth; D010292:Paresthesia / Q000139:chemically induced*; D010787:Photosensitivity Disorders / Q000139:chemically induced; D011292:Premedication; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014182:Transplantation, Autologous
chemical_list: D018906:Antineoplastic Agents, Alkylating; D016207:Cytokines; D004091:Hydromorphone; D002330:Carmustine; D006854:Hydrocortisone