Successful desensitization in a patient with recurrent anaplastic oligodendroglioma presenting with procarbazine-mediated anaphylaxis.

INTRODUCTION: Procarbazine is an oral chemotherapeutic agent used in the treatment of brain malignancies and is associated with hypersensitivity reactions. In case of grade 4 reactions, rechallenge should be avoided, and the agent should be replaced, unless the treatment is curative, in which case the application of a desensitization protocol should be considered. We present a successful case of desensitization in procarbazine anaphylaxis. CASE REPORT: A 53-year-old male patient was diagnosed with recurrent anaplastic oligodendroglioblastoma. The patient received three cycles of procarbazine, lomustine, and vincristine chemotherapy for malignancy recurrence. In the fourth cycle, on the 12th day of procarbazine treatment, the patient developed anaphylaxis. Procarbazine was given together with premedication as part of the 12-step desensitization process, and the fourth cycle was successfully completed. MANAGEMENT AND OUTCOME: Procarbazine hypersensitivity reactions are observed less frequently than reactions to other chemotherapeutics. We presented a case of procarbazine-associated severe anaphylaxis that was able to continue procarbazine chemotherapy with successful desensitization. This case is important in terms of confirming the procarbazine desensitization protocol. DISCUSSION: In literature there is only one protocol developed was successfully applied in one patient with procarbazine anaphylaxis. In the current case, we took this protocol into consideration in the management of our patient. Following the use of this protocol, the patient was able to continue procarbazine chemotherapy successfully. Procarbazine anaphylaxis is rare, and more cases are needed to be reported to confirm the desensitization protocol and when to continue procarbazine treatment.

Effect of Pulmonary Functions on Survival in Patients with Operable Non-small Cell Lung Cancer.

OBJECTIVE: To investigate the prognostic importance of pulmonary functions and their effect on survival in patients with operable non-small cell lung cancer (NSCLC), who underwent surgical resection and/or received medical treatment. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: University of Health Sciences, Diskapi Training and Research Hospital, Ankara, Turkey, between June 2013 and March 2020. METHODOLOGY: The study included a total of 70 patients diagnosed with non-small cell lung cancer (NSCLC), comprising 35 who underwent surgical treatment and 35 who were treated medically. The effects of age, gender, additional comorbidities, smoking status, complications after surgery and/or radiotherapy, and pulmonary function test values ​​on survival were investigated. RESULTS:  The median overall survival time of the patients was 1973±769.1 (466-3.480) days. According to the univariate Cox regression analysis, the preoperative and postoperative values of the forced expiratory volume in 1 second were not important risk factors affecting survival (p=0.752 and p=0.878) respectively. A statistically significant difference was observed in survival probability between the patients with and without coronary artery disease (CAD) (p=0.005). There was also a statistically significant difference between the Eastern Cooperative Oncology Group (ECOG) performance groups in terms of survival probability (p<0.001). CONCLUSION: There was no relationship between pulmonary functions and survival in patients with operable NSCLC, but this evaluation should be undertaken in larger patient groups. This study demonstrated the importance of patients' performance status and comorbidities, such as CAD in survival. KEY WORDS: Non-small cell lung cancer, Survival, Respiratory function test.