Evaluation of hypersensitivity reactions to cancer chemotherapeutic agents in pediatric patients

Yagmur, Irem Turgay; Güzelküçük, Zeliha; Yaralı, Neşe; Özyörük, Derya; Toyran, Müge; Civelek, Ersoy; Özbek, Namık; Mısırlıoğlu, Emine Dibek

doi:10.1016/j.anai.2020.01.010

Cited by 14 publications

(12 citation statements)

References 36 publications

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“…The package insert reports anaphylactic‐like reactions including chills, fever, tachycardia, bronchospasm, dyspnea, and hypotension occurring in 0.7%–2% of patients receiving etoposide 5 . Primary literature estimates infusion reactions occur in 1.3%–27.1% of patients receiving etoposide 6,7 . We present a 10‐year experience of etoposide use and describe infusion‐related reactions at two freestanding pediatric hospitals.…”

Section: Introductionmentioning

confidence: 99%

Risks and mitigation strategies to prevent etoposide infusion‐related reactions in children

et al. 2021

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Etoposide is an antineoplastic agent widely used for treatment of many pediatric cancers. Etoposide has been associated with infusion‐related reactions. In this brief report, we compare etoposide infusion‐related reactions that occurred over a 10‐year period at two freestanding pediatric hospitals. Infusion reactions occurred in 1% of patients at two hospitals across the study period. Rates of 4.8%, 3.4%, and 7.9% were observed at Children's Mercy Hospital during 2018, 2019, and 2020, respectively, after the implementation of in‐line filters during etoposide infusions in late 2017. Of the 32 patients who experienced adverse reactions, 41% were rechallenged after the reaction and all were able to tolerate at least one future dose with either pre‐treatment or extending infusion duration. This work highlights the importance of a multicenter approach to investigating adverse drug reactions (ADRs) as variation in practice can provide key information about ADRs and potential risk factors.

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Section: Introductionmentioning

confidence: 99%

Risks and mitigation strategies to prevent etoposide infusion‐related reactions in children

et al. 2021

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“…Dos clases de agentes causan la mayoría de las reacciones en adultos: platinos y taxanos [44]. Para niños, la L-asparaginasa cobra relevancia particular [45].…”

Section: Epidemiologíaunclassified

“…Para los taxanos, los antecedentes de atopia, reacciones cutáneas, la presencia de disfunción respiratoria, obesidad y el estado posmenopáusico, parecen desempeñar un papel relevante [48,52]. En los niños influye la infusión intravenosa, un curso repetido de tratamiento, un intervalo de tiempo ≥1 semana entre infusiones, dosis >6.000 UI/m 2 y quimioterapia de agente único, estos en el caso de uso de Lasparaginasa [45].…”

Section: Epidemiologíaunclassified

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Reacciones de hipersensibilidad a quimioterapéuticos y biológicos

Martínez-Castillo¹,

Ardila-Herrera²,

Calle³

et al. 2022

Med. Lab.

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Las reacciones a medicamentos han aumentado con el tiempo, estas implican ahora una carga importante de enfermedad, principalmente en los servicios de hospitalización. Los agentes quimioterapéuticos y biológicos son fármacos utilizados con frecuencia en enfermedades reumatológicas y neoplasias de diferente orden. Las reacciones de hipersensibilidad a quimioterapéuticos y monoclonales impactan en la calidad de vida, el pronóstico y la mortalidad de los pacientes con enfermedades autoinmunes y cáncer, es por eso que deben ser reconocidas y manejadas por un equipo de trabajo multidisciplinar. La desensibilización es una herramienta terapéutica que ofrece grandes beneficios a los pacientes con reacciones de hipersensibilidad, permitiéndoles la utilización de medicamentos de primera línea de manera segura y costoefectiva, con un impacto importante en la morbilidad y mortalidad de estos pacientes. El objetivo de este artículo fue revisar la información y evidencia más reciente sobre las reacciones de hipersensibilidad a quimioterapéuticos y biológicos, y los datos sobre las opciones de desensibilización con estos medicamentos y su desenlace.

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“…Asparaginase is a mainstay of chemotherapy for acute lymphoblastic leukemia (ALL) but is one of the top five therapeutic compounds known to cause adverse drug reactions [ 1 ]. The adverse infusion reactions associated with asparaginase mostly occur within the first hour, the incidence and severity of them increase with continued dosing, [ 2 ] and, when severe, can lead to omission of subsequent asparaginase doses and reduce event-free survival [ 3 , 4 ]. The forms of asparaginase commonly used include native Escherichia coli ( E. coli ) asparaginase, E. coli asparaginase conjugated with polyethylene glycol (pegaspargase), and Erwinia asparaginase (Erwinase), each of which have different antigenic properties, but all are known to cause infusion reactions.…”

Section: Introductionmentioning

confidence: 99%

Multiple Asparaginase Infusions Cause Increasingly Severe Acute Hyperammonemia

Buddington

Howard

2022

Medical Sciences

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Adverse reactions during and shortly after infusing asparaginase for the treatment of acute lymphoblastic leukemia can increase in severity with later doses, limiting further use and increasing relapse risk. Although asparaginase is associated with hyperammonemia, the magnitude of the increase in serum ammonia immediately after the infusion and in response to multiple infusions has not been examined. The concurrence of hyperammonemia and infusion reactions was studied using weaned juvenile pigs that received 12 infusions of Erwinia asparaginase (Erwinase; 1250 U/kg) over 28 days, with two 5-day recovery periods without asparaginase after the eighth and eleventh doses. Infusion reactions and prolonged hyperammonemia (>50 µM ammonia 48 h after the infusion) began after the fourth dose and increased with later doses. Dense sampling for 60 min revealed an acute phase of hyperammonemia that peaked within 20 min after starting the first infusion (298 + 62 µM) and lasted less than 1 h, without apparent symptoms. A pronounced acute hyperammonemia after the final infusion (1260 + 250 µM) coincided with severe symptoms and one mortality during the infusion. The previously unrecognized acute phase of hyperammonemia associated with asparaginase infusion coincides with infusion reactions. The juvenile pig is a translational animal model for understanding the causes of acute and chronic hyperammonemia, differentiating from hypersensitivity reactions, and for improving infusion protocols to reduce acute hyperammonemia and to allow the continued use of asparaginase.

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Evaluation of hypersensitivity reactions to cancer chemotherapeutic agents in pediatric patients

Cited by 14 publications

References 36 publications

Risks and mitigation strategies to prevent etoposide infusion‐related reactions in children

Risks and mitigation strategies to prevent etoposide infusion‐related reactions in children

Reacciones de hipersensibilidad a quimioterapéuticos y biológicos

Multiple Asparaginase Infusions Cause Increasingly Severe Acute Hyperammonemia

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