Successful desensitization for cytarabine induced anaphylaxis

ABSTRACT

Cytarabine is a very important chemotherapeutic agent for leukemia and lymphoma patients and is prescribed more frequently than before. Cytarabine-induced delayed-onset hypersensitivity may rarely present as non-IgE mediated anaphylaxis. However, we do not know yet whether desensitization therapy in adults may be effective in cytarabine-induced delayed-onset anaphylaxis. A 78-year-old woman who was diagnosed with acute myeloblastic leukemia had chemotherapy including cytarabine. In spite of premedication with hydrocortisone and chlorpheniramine, the patient had anaphylaxis a few hours after cytarabine infusion. We decided to perform desensitization therapy. After desensitization therapy using a newly designed protocol, the patient was tolerable to cytarabine infusion without hypotension or high fever. Desensitization therapy was successfully performed on an adult patient with delayed-onset anaphylaxis caused by cytarabine.