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骨肉瘤患儿大剂量甲氨蝶呤致过敏反应及再次用药成功。

Hypersensitivity reaction to high-dose methotrexate and successful rechallenge in a pediatric patient with osteosarcoma.

机构信息

Pharmaceutical Department, St. Jude Children's Research Hospital, Memphis, Tennessee.

出版信息

Pediatr Blood Cancer. 2014 Feb;61(2):373-5. doi: 10.1002/pbc.24741. Epub 2013 Aug 19.

DOI:10.1002/pbc.24741
PMID:23955991
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4267721/
Abstract

Hypersensitivity reactions to methotrexate are rare, but have been reported. Methotrexate has shown activity against many malignancies, and omission of methotrexate therapy may increase the risk of cancer-related death in some patients. Therefore, rechallenging patients with methotrexate following hypersensitivity may be beneficial. We report a case of a child with metastatic osteosarcoma who experienced a hypersensitivity reaction to high-dose methotrexate and was successfully rechallenged with methotrexate using a 6-hour infusion. Using this regimen, adequate peak methotrexate plasma concentrations were achieved and no further hypersensitivity reactions were noted.

摘要

甲氨蝶呤过敏反应罕见，但已有报道。甲氨蝶呤对许多恶性肿瘤均具有活性，如果停止使用甲氨蝶呤治疗，可能会增加某些患者因癌症相关死亡的风险。因此，对发生甲氨蝶呤过敏反应的患者再次使用甲氨蝶呤可能有益。我们报告了一例患有骨肉瘤转移的儿童，该患儿在接受大剂量甲氨蝶呤治疗时发生过敏反应，随后采用 6 小时输注的方式成功再次使用甲氨蝶呤进行治疗。采用该方案可达到足够的甲氨蝶呤血浆峰浓度，且未再出现过敏反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8a1/4267721/0384c90c9e84/nihms648076f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8a1/4267721/0384c90c9e84/nihms648076f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8a1/4267721/0384c90c9e84/nihms648076f1.jpg

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