Antipyretic effect of indomethacin in patients with malignancy

✍ Scribed by Charles J. Lusch; Arthur A. Serpick; Lewis Slater

• Publisher: John Wiley and Sons
• Year: 1968
• Tongue: English
• Weight: 472 KB
• Volume: 21
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(196804)21:4<781::aid-cncr2820210431>3.0.co;2-t

✦ Synopsis

The antipyretic effect of indomethacin in 30 febrile patients with malignancy was evaluated. Effective antipyresis was observed in 20 of the 30 patients.

Responses were usually prompt and complete and side effects were reported infrequently. Defervescence was obtained much more frequently in those patients whose fever seemed related primarily to the neoplastic process rather than to a complicating infection. In eight patients indomethacin effected a defervescence after another antipyretic had failed to do so. The authors conclude that indomethacin should be considered as an alternate antipyretic in patients with malignancy complicated by fever.

HE DEVELOPMENT OF FEVER IS A COMMON

T complication in the clinical course of the patient with cancer. In the study of Boggs and Freiz fever occurred on 24% of the hospital days of 127 consecutive patients admitted to the National Cancer Institute. I n that group of patients adults with acute leukemia were febrile on 60% of their hospital days while children with acute leukemia had fever on 42% of their hospital days. Fever was next most frequent in Hodgkin's disease (26%), followed by a variety of other malignancies.

T h e appearance of fever in a patient with cancer is generally thought to be related either to activity of the malignancy itself or to the presence of some complicating infection. In about half of the cases it is due to an infectious process and in the rest no infectious agent can be demonstrated.299

T h e manner in which the neoplastic process may produce fever remains unexplained. Results obtained i n two recent studies suggest that fever in Hodgkin's disease may be due to an endogenous protein pyrogen, possibly produced by the neoplastic cell,13 and detectable in the urine.7

T h e presence of fever is usually detrimental, whatever its cause; it frequently causes