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Anaphylactic reaction to polyethylene‐glycol conjugated‐asparaginase: Premedication and desensitization may not be sufficient
Author(s) -
Sahiner Umit M.,
Yavuz S. Tolga,
Gökce Muge,
Buyuktiryaki Betul,
Altan Ilhan,
Aytac Selin,
Tuncer Murat,
Tuncer Ayfer,
Sackesen Cansin
Publication year - 2013
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12131
Subject(s) - premedication , medicine , anaphylaxis , desensitization (medicine) , peg ratio , polyethylene glycol , asparaginase , pharmacology , anesthesia , allergy , immunology , leukemia , lymphoblastic leukemia , chemistry , receptor , organic chemistry , finance , economics
In hypersensitive reactions to native L‐asparaginase, either premedication and desensitization or substitution with polyethylene glycol conjugated asparaginase ( PEG‐ASP ) is preferred. Anaphylaxis with PEG‐ASP is rare. An 8‐year‐old girl and a 2.5‐year‐old boy, both diagnosed as having acute lymphoblastic leukemia, presented with native L‐asparaginase hypersensitivity and substitution with PEG‐ASP was preferred. They received a premedication (methylprednisolone, hydroxyzine and ranitidine) followed by desensitization with PEG‐ASP infusion. Both patients developed anaphylaxis with peg‐asparaginase. These are the first reported cases of anaphylactic reaction to PEG‐ASP , despite the application of both premedication and desensitization. Anaphylaxis with PEG‐ASP is very rare and premedication and desensitization protocols may not prevent these hypersensitive reactions.