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疑似细胞毒药物过敏副作用的复杂临床特征:症状、发病机制、再暴露和脱敏。

The complex clinical picture of presumably allergic side effects to cytostatic drugs: symptoms, pathomechanism, reexposure, and desensitization.

机构信息

Allergology and Oncology Service, Medicine Department, Asola Hospital, Mantova, Italy.

出版信息

Med Clin North Am. 2010 Jul;94(4):835-52, xiii. doi: 10.1016/j.mcna.2010.03.002.


DOI:10.1016/j.mcna.2010.03.002
PMID:20609866
Abstract

The number of drugs used for the treatment of different types of cancers is constantly increasing and actually exceeds 100 distinct chemical formulations. The use of most cytotoxic agents is associated with potential hypersensitivity reactions, and the constant increase of their administration has caused an increase in incidence of these adverse effects, thus becoming a relevant problem for clinicians. Hypersensitivity reactions are common with platinum compounds, L-asparaginase, taxanes, procarbazine, and epipodophyllotoxins, whereas they are unusual, but always possible, with the other chemotherapeutic drugs. Reactions associated with individual drugs are discussed in detail. The mechanism underlying these hypersensitivity reactions involves IgE-mediated hypersensitivity reactions, nonallergic hypersensitivity reactions, and a few pathogenetically unclear reactions. More studies are needed to better understand, diagnose, treat, and prevent these reactions. To achieve this goal, a multidisciplinary approach to treat patients with cancer who have potential allergies is needed.

摘要

用于治疗不同类型癌症的药物数量不断增加,实际上超过了 100 种不同的化学制剂。大多数细胞毒性药物的使用都与潜在的过敏反应有关,而且它们的使用不断增加导致这些不良反应的发生率增加,因此成为临床医生关注的一个问题。过敏反应在铂类化合物、L-天冬酰胺酶、紫杉烷类、丙卡巴肼和鬼臼毒素中很常见,而在其他化疗药物中则不常见,但总是有可能发生。本文详细讨论了与个别药物相关的反应。这些过敏反应的机制涉及 IgE 介导的过敏反应、非过敏过敏反应和一些发病机制尚不清楚的反应。需要进一步研究以更好地理解、诊断、治疗和预防这些反应。为了实现这一目标,需要采用多学科方法来治疗有潜在过敏反应的癌症患者。

相似文献

[1]
The complex clinical picture of presumably allergic side effects to cytostatic drugs: symptoms, pathomechanism, reexposure, and desensitization.

Med Clin North Am. 2010-7

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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引用本文的文献

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Prevalence and management of immediate drug hypersensitivity observed during antineoplastic drug therapy.

Acta Oncol. 2025-4-28

[2]
Management of Patients with Hypersensitivity to Platinum Salts and Taxane in Gynecological Cancers: A Cross-Sectional Study by the European Network of Young Gynaecologic Oncologists (ENYGO).

Cancers (Basel). 2024-3-14

[3]
Desensitization in patients with hypersensitivity to platinum and taxane in gynecological cancers.

Cancer Med. 2024-1

[4]
Allergy in Cancer Care: Antineoplastic Therapy-Induced Hypersensitivity Reactions.

Int J Mol Sci. 2023-2-15

[5]
Omalizumab for successful chemotherapy desensitisation: What we know so far.

Clin Transl Allergy. 2021-12-13

[6]
Hypersensitivity Reaction after Transarterial Chemoembolization.

Semin Intervent Radiol. 2020-10

[7]
Inhibition of Angiogenesis by Treatment with Cold Atmospheric Plasma as a Promising Therapeutic Approach in Oncology.

Int J Mol Sci. 2020-9-26

[8]
Carboplatin-induced Kounis syndrome.

J Cardiol Cases. 2011-5-6

[9]
Hypersensitivity to Carboplatin in Children with Malignancy.

Front Pharmacol. 2017-4-12

[10]
Subgroups of Paediatric Acute Lymphoblastic Leukaemia Might Differ Significantly in Genetic Predisposition to Asparaginase Hypersensitivity.

PLoS One. 2015-10-12

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