Immediate hypersensitivity reaction to pegylated liposomal doxorubicin: management and outcome in four patients

European Journal of Dermatology : EJD
Saskia Ingen-Housz-OroMarie Beylot-Barry

Abstract

Hypersensitivity reactions (HSR) to pegylated liposomal doxorubicin (PLD; Caelyx®) have been reported, and symptoms usually resolve with drug withdrawal. However, the risk of relapse of severe HSR and prevention remain poorly described. To report the management and outcome in four patients with HSR due to PLD. Patient characteristics, premedication regimen, rate of infusion, time between onset and HSR, clinical manifestations, and management were documented. A first cycle of PLD was received for cutaneous T-cell lymphoma (n = 3) and Kaposi sarcoma (n = 1). The drug was diluted in 250 mL 5% glucose and administered over one hour (4.17 mL dilution/min, i.e. 0.6 mg PLD/min for 1.8 m2 body surface area [BSA]). Grade 3 HSR occurred in the first minutes in the four patients. Because of the absence of alternative treatment for the underlying disease, PLD was resumed. Premedication was reinforced with 300 mg oral ranitidine and 50 mg hydroxyzine the night before and the morning of infusion. The rate of infusion was 1 mL dilution/min (0.14 mg PLD/min for 1.8 m2 BSA) for the first 15 minutes. No HSR occurred in three patients. In contrast, severe symptoms appeared in the first seconds of resumption in one patient. To minimise HSR to PLD,...Continue Reading

Citations

Jan 26, 2020·Nanomaterials·Collin T InglutHuang-Chiao Huang
Aug 26, 2020·Annual Review of Pharmacology and Toxicology·Wen YangStefan Wilhelm
Jan 28, 2021·The Journal of Obstetrics and Gynaecology Research·Shinichiro YamaguchiKiyoko Kato
Mar 20, 2021·The Journal of Allergy and Clinical Immunology. in Practice·Maria Luisa CaballeroCosby A Stone

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