INCIDENCE AND CHARACTERIZATION OF IMMEDIATE ADVERSE REACTIONS TO CHEMOTHERAPY INFUSION IN AMBULATORY PATIENTS OF A SENTINEL HOSPITAL

Introduction: Most antineoplastic agents offer risks regarding the occurrence of adverse reactions to infusion. The incidence and profile of these reactions vary according to the pharmacological characteristics of each medicine, and may or may not be immunomediated. Due to their systemic unspecific action, chemotherapeutics act indiscriminately throughout the body, which can lead to severe adverse reactions. Objective: Investigate and characterize the immediate adverse reactions to chemotherapy infusion in ambulatory patients notified in a sentinel hospital. Method: This is an exploratory-descriptive study, with a retrospective and prospective approach, carried out between March 2018 and June 2019, approved by the institutional ethics committee under the registry CAAE 06213518.8.0000.5243. A form was developed for this study, in order to best adequate the information obtained from the adverse reaction notification registry, directed to the hospitals risk management department. Further information required for the investigation of adverse reactions was complemented by researching medical records. Reactions to infusion were later classified according to severity, to the Common Terminology Criteria for Adverse Events (CTCAE) and to causality using the Naranjo algorithm. The data was registered in EXCEL 2007 and submitted to descriptive analysis. Results: 30 immediate adverse reactions to chemotherapy infusion were registered, involving 28 patients (83% female and 17% male), mainly with Paclitaxel (44%), Carboplatin (20%), Oxaliplatin (14%) e Docetaxel (13%). According to the Naranjo algorithm, 60% of reactions had the chemotherapeutics as probable cause. The average interval between infusion and the beginning of reactions was 40 minutes, with the most precocious manifestation being observed with Docetaxel (5 minutes), and the latest with Oxaliplatin (135 minutes). The severity of reactions varied from mild (60%) and moderate (33%). The most compromised organics segments were the cardiovascular (27%) and respiratory (26%) systems, and 83% of all symptoms were already described in databases. Conclusion: Hypersensitivity reactions to Paclitaxel corresponded to the majority of notified events. Despite being mild, these reactions can impact directly on the patients adherence to the treatment, therefore the monitoring of chemotherapy infusion must be uninterrupted.