title: Hypersensitivity reaction to high-dose methotrexate and successful rechallenge in a pediatric patient with osteosarcoma.
abstract: Hypersensitivity reactions to methotrexate are rare, but have been reported. Methotrexate has shown activity against many malignancies, and omission of methotrexate therapy may increase the risk of cancer-related death in some patients. Therefore, rechallenging patients with methotrexate following hypersensitivity may be beneficial. We report a case of a child with metastatic osteosarcoma who experienced a hypersensitivity reaction to high-dose methotrexate and was successfully rechallenged with methotrexate using a 6-hour infusion. Using this regimen, adequate peak methotrexate plasma concentrations were achieved and no further hypersensitivity reactions were noted.
authors: Pharmaceutical Department, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors: Jeffrey R
authors: JR
authors: Scott
authors: Deborah A
authors: DA
authors: Ward
authors: Kristine R
authors: KR
authors: Crews
authors: John C
authors: JC
authors: Panetta
authors: Fariba
authors: F
authors: Navid
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000188:drug therapy; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000150:complications / Q000188:drug therapy*; D002648:Child; D003888:Desensitization, Immunologic; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008727:Methotrexate / Q000627:therapeutic use*; D012516:Osteosarcoma / Q000150:complications / Q000188:drug therapy*; D011379:Prognosis
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate
keywords: anaphylaxis; hypersensitivity; methotrexate; osteosarcoma; pediatric
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