Practitioner's Corner
PRACTITIONER'S CORNER Successful Desensitization to Irinotecan After Severe The response of the liver metastases to chemotherapy was Hypersensitivity Reaction poor, so it was decided to administer 4 cycles of irinotecan- loaded drug-eluting beads (DEBIRI, BTG) via intra-arterial infusion. The patient received 100 mg of irinotecan in DC Cubero JL1,2, Escudero P2,3, Yubero A2,3, Millán P4, Sagredo MA5, Bead (an embolic drug-eluting bead for controlled loading Colás C1,2 and release of chemotherapeutic agents) (BTG) of 100- 1Allergy Department, University Hospital Lozano Blesa of 300 µm between May and September 2015 and showed no Zaragoza, Zaragoza, Spain hypersensitivity symptoms. 2Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain Owing to disease progression (enlargement of the liver 3Oncology Department, University Hospital Lozano Blesa of nodules and emergence of new liver foci and pulmonary Zaragoza, Zaragoza, Spain nodules), treatment was initiated 2 months later with 4Intensive Care Unit, University Hospital Lozano Blesa of aflibercept in combination with FOLFIRI (irinotecan, calcium Zaragoza, Zaragoza, Spain levofolinate, and 46-hour 5-fluorouracil in a continuous 5Pharmacy Department, University Hospital Lozano Blesa of infusion). In the first cycle, during the administration of Zaragoza, Zaragoza, Spain irinotecan alone, the patient presented lingual angioedema, generalized urticaria, desaturation, and blurred vision that J Investig Allergol Clin Immunol 2016; Vol. 26(5): 314-316 doi: 10.18176/jiaci.0075 lasted 6 hours and required various doses of corticosteroids, systemic antihistamines, and oxygen. Given the severity of Key words: Desensitization. Hypersensitivity reactions. Irinotecan. the reaction, calcium levofolinate and 5-fluorouracil were discontinued. Before the diagnosis of allergy to irinotecan, Palabras clave: Desensibilización.
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