Alopecia paclitaxel

Paclitaxel Peripheral neuropathy (DLT), nausea/vomiting, alopecia, hypersensitivity reactions Use caution with any elevation in AST (SGOT). Give proper dosing for liver dysfunction. Premedicate dexamethasone, diphenhydramine, and cimetidine. 

Most anticancer drugs damage hair follicles and produce partial or complete alopecia. Patients should be warned of this reaction, especially if paclitaxel, cyclophosphamide, doxorubicin, vincristine, methotrexate, or dactinomycin is used. Hair usually regrows normally after completion of chemotherapy. 

Myelosuppression is the major side effect of paclitaxel. Alopecia is common, as is reversible dose-related peripheral neuropathy. Most patients have mild numbness and tingling of the fingers and toes beginning a few days after treatment. Mild muscle and joint aching also may begin 2 or 3 days after initiation of therapy. Nausea is usually mild or absent. Severe hypersensitivity reactions may occur. Cardiovascular side effects, consisting of mild hypotension and bradycardia, have been noted in up to 25% of patients. 

The other toxicities of carboplatin are generally milder and better tolerated than those of cisplatin. Nausea and vomiting, though frequent, is less severe, shorter in duration, and more easily controlled with standard antiemetics (for example compazine, dexamethasone, lorazepam) than that following cisplatin treatment. Renal impairment is infrequent, though alopecia is common, especially with the paclitaxel-containing combinations. Neu-... 

The plant alkaloids (vincristine, vinblastine, vindesine and vinorelbine) and taxoids (paclitaxel, docetaxel) inhibit microtubule assembly and cause cell cycle arrest in mitosis. They particularly cause bone marrow depression, peripheral neuropathy (vincristine) and alopecia. Etoposide blocks the cell cycle before mitosis. 

Alopecia occurs in nearly aU patients who receive paclitaxel, but it has unique characteristics. Hair loss is sudden and complete, and many patients often experience loss of all body hair, including axillary and pubic hair, eyelashes, and eyebrows (28,44). The loss of body hair often occurs with cumulative therapy and is more severe after longer infusion times. 

Paclitaxel Bone marrow suppression, peripheral neuropathy, alopecia... 

In phase I and phase II studies DHA paclitaxel has been administered with glucocorticoid and antihistamine premedication [104, 1085]. However, there have been reports of hypersensitivity reactions despite this [104]. A significant difference compared with conventional paclitaxel is the relatively small incidence of peripheral neuropathy and no reports of alopecia so far [102f 106 ]. 

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