Anaphylactic reaction to polyethylene-glycol conjugated-asparaginase: Premedication and desensitization may not be sufficient

作者：Sahiner Umit M; Yavuz S Tolga; Gokce Muge; Buyuktiryaki Betul; Altan Ilhan; Aytac Selin; Tuncer Murat; Tuncer Ayfer; Sackesen Cansin^*

来源：Pediatrics International, 2013, 55(4): 531-533.

DOI：10.1111/ped.12131

• anaphylaxis
• desensitization
• hypersensitivity
• polyethylene-glycol asparaginase
• premedication

In hypersensitive reactions to native L-asparaginase, either premedication and desensitization or substitution with polyethylene glycol conjugated asparaginase (PEG-ASP) is preferred. Anaphylaxis with PEG-ASP is rare. An 8-year-old girl and a 2.5-year-old boy, both diagnosed as having acute lymphoblastic leukemia, presented with native L-asparaginase hypersensitivity and substitution with PEG-ASP was preferred. They received a premedication (methylprednisolone, hydroxyzine and ranitidine) followed by desensitization with PEG-ASP infusion. Both patients developed anaphylaxis with peg-asparaginase. These are the first reported cases of anaphylactic reaction to PEG-ASP, despite the application of both premedication and desensitization. Anaphylaxis with PEG-ASP is very rare and premedication and desensitization protocols may not prevent these hypersensitive reactions.

• 出版日期2013-8