Delayed Hypersensitivity Reaction to Leucovorin

Gudimetla, Vishnu; Daw, Jad; Almhana, Farah; Haddad, Abdo

doi:10.1097/mjt.0000000000000977

Cited by 2 publications

(1 citation statement)

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“…Leucovorin-induced HSRs can manifest with a variety of symptoms, ranging from mild symptoms such as pruritus and urticaria to more severe manifestations including anaphylaxis. 13,14 These reactions can manifest either shortly after the first leucovorin infusion or, as in our case, after several cycles of chemotherapy. There have been reported cases of HSRs attributed to leucovorin (Table 3).…”

Section: Discussionmentioning

confidence: 51%

Leucovorin-induced Hypersensitivity Reaction in a Patient with Metastatic Colorectal Cancer Treated with Cetuximab Plus FOLFOX Chemotherapy: A Case Report

Kim,

Lee

et al. 2023

Korean J Gastroenterol

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The FOLFOX regimen (combination of leucovorin, 5-fluorouracil, and oxaliplatin) is the first-line treatment for high-risk stage 2 and 3 colorectal cancer patients. While hypersensitivity reactions (HSRs) caused by oxaliplatin are commonly reported, HSRs due to leucovorin have been infrequently reported. This report aims to investigate the clinical presentation, diagnosis, and management of leucovorin induced HSRs. A 60-year-old female developed generalized edema, dyspnea, and facial redness during cetuximab plus FOLFOX chemotherapy administered for management of metastatic colorectal cancer. Because HSRs induced by oxaliplatin are commonly reported, we initially presumed an oxaliplatin-induced HSR. However, despite undergoing oxaliplatin desensitization, HSRs persisted, and they were still observed when leucovorin was administered without oxaliplatin. The patient was diagnosed with leucovorin-induced HSR and underwent leucovorin desensitization. However, the reactions recurred within 30 minutes of the initiating the desensitization. Considering unsuccessful leucovorin desensitization, leucovorin was excluded. The patient received cetuximab and oxaliplatin chemotherapy without leucovorin to date without any adverse effects. While leucovorin-induced HSRs are infrequently reported, they should still be regarded as potential adverse effects.

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Section: Discussionmentioning

confidence: 51%