Essayan D M, Kagey-Sobotka A, Colarusso P J, Lichtenstein L M, Ozols R F, King E D
Division of Clinical Immunology, Johns Hopkins Asthma & Allergy Center, Baltimore, MD 21224, USA.
J Allergy Clin Immunol. 1996 Jan;97(1 Pt 1):42-6. doi: 10.1016/s0091-6749(96)70281-6.
Paclitaxel, a member of a new class of antineoplastic agents called the taxanes, has been associated with anaphylactoid reactions.
We report a case of successful parental desensitization to paclitaxel.
Desensitization was performed with serial 10-fold dilutions (up to 1:100,000) of paclitaxel in sufficient volume to administer successive doses of 1, 2, 4, and 8 ml. Basophil histamine release tests were performed with paclitaxel alone, vehicle alone, and paclitaxel and vehicle combined to determine which agent was responsible for the anaphylactoid reactions.
After parental desensitization was performed, the patient was able to tolerate infusion of paclitaxel without complications or need for antihistamines or steroids. Basophil histamine release occurred only with paclitaxel and not with the vehicle.
Successful parenteral desensitization to paclitaxel can be achieved; it is paclitaxel, and not its vehicle, that is most likely responsible for anaphylactoid reactions in patients undergoing treatment.
紫杉醇是一类名为紫杉烷类的新型抗肿瘤药物中的一员，它与类过敏反应有关。
我们报告一例成功进行紫杉醇静脉脱敏治疗的病例。
使用紫杉醇的系列10倍稀释液（最高至1:100,000）进行脱敏，稀释液体积足以给予1、2、4和8毫升的连续剂量。分别用单独的紫杉醇、单独的溶媒以及紫杉醇与溶媒混合液进行嗜碱性粒细胞组胺释放试验，以确定哪种药物导致类过敏反应。
静脉脱敏治疗后，患者能够耐受紫杉醇输注，无并发症发生，也无需使用抗组胺药或类固醇。嗜碱性粒细胞组胺释放仅在使用紫杉醇时出现，而使用溶媒时未出现。
可以成功实现对紫杉醇的静脉脱敏；接受治疗的患者发生类过敏反应最可能的原因是紫杉醇本身，而非其溶媒。
