Effects of diluent volume and administration time on the incidence of anaphylaxis following docetaxel therapy in breast cancer

Abstract

Hypersensitivity reactions, including anaphylaxis, are common side effects associated with docetaxel treatment in breast cancer patients. However, preventive measures have not yet been established. In this study, we retrospectively analyzed the risk factors for developing anaphylaxis in 182 female breast cancer patients treated with docetaxel. We found that 6.6% of all patients (n=12) experienced anaphylaxis. Multivariate analyses indicated that concentration of docetaxel higher than 0.275mg/m2/mL, docetaxel dose rate higher than 1.15mg/m2/min, and white blood cell count less than 4290 cells/mL are risk factors for developing docetaxel-related anaphylaxis. In particular, concentrations of docetaxel or doses per administration time were associated with a high odds ratio (11.88 or 11.60) for docetaxel-related anaphylaxis. Moreover, patients receiving doses in 250mL volume experienced anaphylaxis more frequently than those receiving doses in 500mL (7.0 vs. 0.9%, p=0.0236). Additionally, patients receiving treatments over 60min tended to experience anaphylaxis more frequently than those who were treated over 90min (6.7 vs. 1.1%, p=0.0637). The present results indicate that high docetaxel concentrations, high dose rates, and low white blood cell counts are risk factors for developing docetaxel-related anaphylaxis, and administering docetaxel diluted in 500mL over 90min may limit docetaxel-induced hypersensitivity reactions.