title: Fever Therapy With Intravenously Applied Mistletoe Extracts for Cancer Patients: A Retrospective Study.
abstract: So-called spontaneous remissions in cancer often seem to occur after febrile events. Mistletoe preparations (MPs) are used off-label intravenously to induce fever within concepts of integrative oncology. We wanted to investigate the frequency of febrile reactions and safety related to intravenously applied MPs (IAMPs).
  
  
  
  This was a retrospective analysis of data from consecutive cancer patients who were treated in 2 anthroposophic hospitals with IAMPs. The main outcome parameter was the rate of core temperature increase to ≥38.5°C within 24 hours after IAMPs. Secondary outcome parameters were Common Toxicity Criteria for Adverse Events (CTCAE; version 4.0).
  
  
  
  59 patients, with in total 567 IAMPs, were analyzed; 45 patients (76%, 95% CI = 65%-87%) had an increase of core temperature to ≥38.5°C after at least 1 treatment. Mean increase in temperature was 1.5°C ± 0.8°C. Adverse events were mostly fever-related symptoms (headache, joint pain, shivering). Grade 1 allergic reactions were documented in 0.6% of treatments. CTCAEs grade 3 to 5 did not occur; 38/59 patients had advanced and/or metastatic disease.
  
  
  
  IAMPs resulted in febrile reactions to >38.5°C in the majority of patients and can be considered as safe. Adverse events were mostly related to fever and were not severe.
authors.affiliation: 1 Cantonal Hospital St Gallen, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Schläppi
authors.affiliation: 2 University Medical Center Freiburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Ewald
authors.affiliation: 3 Klinik Arlesheim, Haus Lukas, Switzerland.
authors.forename: Jürgen Johannes
authors.initials: JJ
authors.lastname: Kuehn
authors.affiliation: 2 University Medical Center Freiburg, Germany.
authors.forename: Tomas
authors.initials: T
authors.lastname: Weinert
authors.affiliation: 2 University Medical Center Freiburg, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Huber
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D001831:Body Temperature / Q000187:drug effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology; D005260:Female; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D014784:Mistletoe / Q000033:anatomy & histology / Q000737:chemistry*; D009369:Neoplasms / Q000628:therapy*; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D010936:Plant Extracts
keywords: Viscum album; adverse events; anthroposophic medicine; safety