Etoposide
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Hypersensitivity in a child, managed with desensitisation: case report An 8-year-old boy with acute lymphoblastic leukaemia developed a hypersensitivity reaction to etoposide [dosage not stated]; he was successfully desensitised. In 2005, the boy underwent chemotherapy for acute lymphoblastic leukaemia L1 using the St. Jude XIIIB protocol, which included etoposide. By treatment week 40, he had experienced two episodes of urticaria and angioedema which required treatment dilution and administration of steroids and antihistamines prior to etoposide infusion. This enabled him to complete 120 weeks of treatment. A CNS relapse in July 2008 was managed with chemotherapy using the same etoposidebased protocol with additional radiotherapy. During treatment, he developed urticaria and angioedema with asparaginase. The symptoms did not recur after the rate of asparaginase infusion was reduced. A more severe hypersensitivity reaction developed after etoposide administration, despite premedication with steroids and antihistamines and receiving a diluted formulation of etoposide. During this episode, he developed hypotension and wheezing, in addition to urticaria and angioedema. The boy underwent etoposide desensitisation, using a 12-step protocol; desensitisation was successful after two attempts. During the first attempt, he developed angioedema, urticaria and wheezing. The procedure was suspended and he received antihistamines and IV steroids, including a 4-week course of ketotifen. During the second attempt, etoposide was administered without complications. He was able to tolerate subsequent doses on an outpatient basis without adverse effects. Alvarez Cardona A, et al. Desensitization to etoposide. A case report. Revista Alergia Mexico 57: 33-36, No. 1, Feb 2010 [Spanish; summarised from a 803021402 translation] - Mexico
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Reactions 26 Jun 2010 No. 1307
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