title: Successful use of palifermin following severe anaphylaxis to pegaspargase in a pediatric patient with acute lymphoblastic leukemia.
abstract: Palifermin and pegaspargase are Escherichia coli-derived drug products. Hypersensitivity reactions, including anaphylaxis, are frequently reported with pegaspargase. In high-risk acute lymphoblasic leukemia (ALL), patients undergoing allogeneic hematopoietic stem cell transplant may be treated with palifermin as a supportive care measure for mucositis prophylaxis. However, no literature exists documenting the cross-reactivity between palifermin and pegaspargase. We report a case in which a child with very high-risk ALL having experienced severe anaphylaxis with pegaspargase was later successfully treated with palifermin during stem cell transplant conditioning.
authors.affiliation: Department of Pharmacy, University of North Carolina Health Care, USA katie.kaminski@unchealth.unc.edu.
authors.forename: Katie S
authors.initials: KS
authors.lastname: Kaminski
authors.affiliation: Department of Pharmacy, University of North Carolina Health Care, USA.
authors.forename: Cassidy L
authors.initials: CL
authors.lastname: Beach
authors.affiliation: Department of Pediatrics, University of North Carolina Health Care, USA School of Medicine, University of North Carolina, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Peden
authors.affiliation: School of Medicine, University of North Carolina, USA Department of Allergy and Immunology, University of North Carolina Health Care, USA.
authors.forename: Uyenphuong
authors.initials: U
authors.lastname: Le
authors.affiliation: Department of Pediatrics, University of North Carolina Health Care, USA School of Medicine, University of North Carolina, USA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Roehrs
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001215:Asparaginase / Q000009:adverse effects*; D002675:Child, Preschool; D051523:Fibroblast Growth Factor 7 / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011092:Polyethylene Glycols / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy*; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents; D051523:Fibroblast Growth Factor 7; D011092:Polyethylene Glycols; C042705:pegaspargase; D001215:Asparaginase
keywords: Pediatric oncology; cross-reactivity; hypersensitivity; palifermin; pegaspargase