title: Epistaxis during treatment with paclitaxel.
abstract: The purpose of this study was to determine the incidence and severity of epistaxis in patients treated with paclitaxel. Patients who were treated with paclitaxel filled a questionnaire regarding their general health, medications and incidents of epistaxis. Relevant clinical information was obtained from the patients' charts. Forty-seven consecutive patients were recruited to the study. Twenty-four (51%) of the patients reported epistaxis during paclitaxel therapy. Twenty-three of 39 (59%) patients who received weekly paclitaxel had epistaxis at least once during treatment, compared with one out of eight patients who were treated every 3 weeks (P = 0.045). All episodes of epistaxis were mild, occurred with normal platelets counts and did not require blood product transfusions or treatment modification. The majority of the patients experienced the first episode of epistaxis on the third week of weekly paclitaxel treatment and then repeatedly throughout therapy. It is concluded that epistaxis is a common mild side-effect of weekly paclitaxel that has not been reported previously. In this trial, epistaxis did not have any major clinical consequences. However, when paclitaxel is combined with other drugs that may cause bleeding, such as bevacizumab, physicians should be alerted to the potential risk of this phenomenon.
authors.affiliation: Oncology Department, Assaf-Harofeh Medical Center, Zerifin 70300, Israel. nirit.yarom@gmail.com
authors.forename: Nirit
authors.initials: N
authors.lastname: Yarom
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Cyjon
authors.forename: Svetlana
authors.initials: S
authors.lastname: Kovel
authors.forename: Adelya
authors.initials: A
authors.lastname: Yachnin
authors.forename: Avishay
authors.initials: A
authors.lastname: Sella
authors.forename: Ella
authors.initials: E
authors.lastname: Evron
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D004334:Drug Administration Schedule; D004844:Epistaxis / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010976:Platelet Count; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel