Significant toxicities and effects have been identified for specific agents. These require effective management.
Flu like symptoms
Flu like symptoms are commonly associated with the anti-cytokine therapies such as the interleukins and interferons. Symptoms can be more severe when higher doses are administered.9, 10 Flu like symptoms have also been associated with monoclonal antibodies.
A phenomenon of tachyphylaxis can develop where the body adapts to certain flu like symptoms (fever, chills, and rigors) and the severity and occurrence decreases with repeated doses of the agent. Other symptoms such as malaise and fatigue are cumulative and dose limiting.
Flu like symptoms include:9
- rapid onset for interferons and monoclonal antibodies
- delayed onset in IL-2
- low grade fevers may occur with colony stimulating factors such as G-CSF
- chills and rigors
- occur prior to temperature spikes with interferons, interleukins, and monoclonal antibodies
- myalgia or arthralgia, headache, malaise, and fatigue
- occur commonly with the interferons and interleukins
- monoclonal antibodies commonly cause arthralgia and malaise, while headache is uncommon and fatigue is rare.
Describe the interventions to prevent, minimise, and/or manage flu like symptoms associated with monoclonal antibody administration.