Bouchireb Karim, Dodille Aurélie, Ponvert Claude, Gouraud François, Dubrel Marie, Brugières Laurence
Department of Pediatrics and Adolescent Oncology, Institut Gustave Roussy, Villejuif, France.
Pediatr Blood Cancer. 2009 Feb;52(2):295-7. doi: 10.1002/pbc.21742.
Anaphylactic/anaphylactoid reactions to methotrexate are rare. In patients with methotrexate-induced anaphylaxis, discontinuation of treatment may increase the risk of death due to cancer progression. In such patients, desensitization may enable the patient to continue treatment with methotrexate. We report the case of a child with metastatic osteosarcoma, who experienced an anaphylactic/anaphylactoid reaction to methotrexate. Skin tests with methotrexate were not performed because their diagnostic value is controversial. Desensitization with methotrexate was successful and allowed the patient to complete 12 additional courses of chemotherapy. Thus, we confirm that desensitization may be a safe procedure in patients with cancer who experience methotrexate-induced anaphylaxis.
甲氨蝶呤引起的过敏反应/类过敏反应较为罕见。在甲氨蝶呤诱发过敏反应的患者中，停止治疗可能会增加因癌症进展而死亡的风险。在此类患者中，脱敏治疗或许能使患者继续接受甲氨蝶呤治疗。我们报告了一例患有转移性骨肉瘤的儿童病例，该患儿对甲氨蝶呤发生了过敏反应/类过敏反应。由于甲氨蝶呤皮肤试验的诊断价值存在争议，因此未进行该项检查。甲氨蝶呤脱敏治疗取得成功，使该患者得以完成另外12个疗程的化疗。因此，我们证实，对于发生甲氨蝶呤诱发过敏反应的癌症患者，脱敏治疗可能是一种安全的方法。
