Successful parenteral desensitization to paclitaxel.
BACKGROUND
Paclitaxel, a member of a new class of antineoplastic agents called the taxanes, has been associated with anaphylactoid reactions.


OBJECTIVE
We report a case of successful parental desensitization to paclitaxel.


METHODS
Desensitization was performed with serial 10-fold dilutions (up to 1:100,000) of paclitaxel in sufficient volume to administer successive doses of 1, 2, 4, and 8 ml. Basophil histamine release tests were performed with paclitaxel alone, vehicle alone, and paclitaxel and vehicle combined to determine which agent was responsible for the anaphylactoid reactions.


RESULTS
After parental desensitization was performed, the patient was able to tolerate infusion of paclitaxel without complications or need for antihistamines or steroids. Basophil histamine release occurred only with paclitaxel and not with the vehicle.


CONCLUSIONS
Successful parenteral desensitization to paclitaxel can be achieved; it is paclitaxel, and not its vehicle, that is most likely responsible for anaphylactoid reactions in patients undergoing treatment.
Essayan
D M
DM
Division of Clinical Immunology, Johns Hopkins Asthma & Allergy Center, Baltimore, MD 21224, USA.
Kagey-Sobotka
A
A
Colarusso
P J
PJ
Lichtenstein
L M
LM
Ozols
R F
RF
King
E D
ED
D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D003536:Cystadenocarcinoma / Q000188:drug therapy*; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000009:adverse effects*
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel