Faculty of Medicine, Division of Allergy and Clinical Immunology, Hacettepe University Hospital, Ankara, Turkey.
Faculty of Medicine, Division of Allergy and Clinical Immunology, Adıyaman University Education and Training Hospital, Adıyaman, Turkey.
J Oncol Pharm Pract. 2024 Jul;30(5):937-940. doi: 10.1177/10781552241226861. Epub 2024 Jan 22.
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.
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.
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.
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.
丙卡巴肼是一种口服化疗药物，用于治疗脑恶性肿瘤，并与过敏反应相关。对于 4 级反应，应避免再次用药，且应更换药物，除非治疗是治愈性的，在这种情况下应考虑采用脱敏方案。我们报告了一例丙卡巴肼过敏反应脱敏成功的病例。
一名 53 岁男性患者被诊断为复发性间变性少突胶质细胞瘤。该患者因恶性肿瘤复发接受了三个周期的丙卡巴肼、洛莫司汀和长春新碱化疗。在第四个周期，丙卡巴肼治疗的第 12 天，患者出现了过敏反应。丙卡巴肼与预处理药物一起给药，作为 12 步脱敏过程的一部分，成功完成了第四个周期。
丙卡巴肼过敏反应比其他化疗药物的反应少见。我们报告了一例丙卡巴肼相关的严重过敏反应病例，该病例通过成功脱敏得以继续丙卡巴肼化疗。该病例在确认丙卡巴肼脱敏方案方面具有重要意义。
文献中仅有一个成功应用于一例丙卡巴肼过敏反应患者的方案。在当前病例中，我们在管理患者时考虑了该方案。在使用该方案后，患者得以成功继续丙卡巴肼化疗。丙卡巴肼过敏反应罕见，需要更多病例报告来确认脱敏方案和何时继续丙卡巴肼治疗。
