title: [Etoposide desensitization. A case report].
abstract: All chemotherapeutic agents have the potential to induce hypersensitivity reactions and the repeated administration of such drugs during a cancer treatment enhances specific sensitization. Epipodophyllotoxins (etoposide and teniposide) are commonly used to treat lung, testicular, central nervous system and hematologic cancers. Hypersensitivity reactions to epipodophyllotoxins are not the most common but they have been reported. We present a case of an eight-year-old male patient, diagnosed with high risk acute lymphoblastic leukemia who received treatment with etoposide among other drugs (St. Jude XIIIB). During the first course of treatment he needed premedication to etoposide administration because of mild hypersensitivity reactions. At the beginning of a second treatment the patient presented two severe hypersensitivity reactions (acute urticaria, angioedema and hypotension) despite the use of premedication and slow infusion. We initiated a twelve steps desensitization protocol for etoposide with success in the second round allowing the administration of further doses in an ambulatory unit without hypersensitivity reactions.
authors.affiliation: Instituto Nacional de Pediatria, Insurgentes sur 3700-C, colonia Insurgentes Cuicuilco, CP 04530, DF Mexico. dr.aristoteles@yahoo.com.mx
authors.forename: Aristóteles
authors.initials: A
authors.lastname: Alvarez Cardona
authors.forename: Leticia
authors.initials: L
authors.lastname: Hernández Nieto
authors.forename: Martín
authors.initials: M
authors.lastname: Pérez Gómez
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pedroza Meléndez
authors.forename: José G
authors.initials: JG
authors.lastname: Huerta López
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002648:Child; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000209:etiology / Q000628:therapy*; D005047:Etoposide / Q000009:adverse effects*; D006801:Humans; D008297:Male
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005047:Etoposide