Some chemotherapy drugs can cause severe anaphylaxis, among them are L-asparagenase (requires small test dose - should be IM, QUESTION MD carefully before giving IV), Bleomycin, Taxol, and Taxotere. Most of these drugs have extensive pre-meds (Tylenol 650mg, Benedryl 25-50 mg, Decadron 10-40mg, Zofran 32mg OR AnzemetOR Kytril 1mg, Solumedrol, and Tagamet). Yet pt can still develop anaphylaxis - usually shortly after infusion begins. I have seen it happen -pts went to the unit, but didn't die. Ocassionally developed some renal failure. Other drugs used in cancer Tx such as biotherapies of Campath, Myelotarg, and Retuxin can cause adverse reactions, as well high rates of fever/hypotension - Biotherapies tend to be "big bags full of Flu symptoms". Rarily fatal if managed well, but highly unpleasant.
ALL GOOD chemotherapy units keep anaphylaxis kits available for just these problems. Most units keep an open line of saline available, if problems occur. And if a reaction occurs in an OP setting, the patient should receive any additional chemos IN THE HOSPITAL.
Judicious use of decadron and kytril/zofran/anzemet usually takes care of nausea.
Some chemos are incredibly cardiotoxic, especially the red chemos (reddish/orange in color) and have lifetime max doses. Some chemos are severely renally toxic (carboplatin, cisplatin) and you must insure copious OP. The Vinca alkaloids (vincristine, vinblastine) are neuro toxic and pts may develop peripheral neurapathies. The Vincas and the red chemos also are vesicants must be given IV as they will destroy tissue if they leak or go SQ (may require graftsor amputation) . VP16 (etopiside can cause severe hypotension), Bleomycin can cause severe pulomonary damage. Leukemics can develop leukostasis complications in lungs (WBC so high that the blood stream does not have enough red cells near lungs to carry sufficient O2 to body - PT must go on vent), Tumor lysis syndrome (break up of tumor cells so fast, the shower of breakup byproducts will cause renal or cardiac failure),or DIC. These are but a few examples of oncological emergencies.
Needless, to say, all chemo pts are (or should be)on strict I/0, VS checks, listen to heart/lung sounds, assess daily weights and edema, as well CBC, Chem profiles, at minimum. All IV accesses must be maintained judiciously.