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September 16, 1974

Febrile Response to Cytarabine

Author Affiliations

City of Hope National Medical Center Duarte, Calif

JAMA. 1974;229(12):1578. doi:10.1001/jama.1974.03230500014006

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To the Editor.—  During our increased utilization of cytarabine (Cytosar) especially in therapy of acute leukemia, we noted that four of approximately 105 of our patients treated had recurrent febrile responses during therapy with the drug. This fever may be either a single spike reaching 38 to 39 C (100 to 102 F) in an otherwise afebrile patient, or it may be a recurrent remittent fever. Attempts to culture a causative bacterial organism, both aerobic and anaerobic, out of the blood, urine, or sputum have been unsuccessful. It can be argued that patients with low peripheral granulocyte counts are always infected and that this is the cause of the fever. One of our patients, however, is a 27-year-old Filipino woman, who has had maintenance therapy consisting of cytarabine administered intravenously for five successive nights at monthly intervals during the past two years. Her peripheral white blood cell count has never