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Desensitization to 5-fluorouracil.

T Eppinger1, K Sperber

  • 1Division of Clinical Immunology, Mount Sinai Medical Center, New York, New York 10029, USA.

Allergy and Asthma Proceedings
|July 2, 1999
PubMed
Summary

Anaphylactic reactions to 5-fluorouracil (5-FU) are rare but serious. A novel desensitization protocol successfully managed a patient with ovarian cancer experiencing severe 5-FU hypersensitivity.

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Area of Science:

  • Oncology
  • Clinical Pharmacology
  • Immunology

Background:

  • Anaphylaxis to 5-fluorouracil (5-FU) is an uncommon but potentially severe adverse drug reaction.
  • Ovarian cancer patients receiving 5-FU chemotherapy are at risk for hypersensitivity reactions.
  • Standard premedication may not prevent 5-FU-induced anaphylaxis.

Observation:

  • A 40-year-old female with ovarian adenocarcinoma experienced two immediate anaphylactic reactions during 5-FU infusions.
  • The second reaction occurred despite prophylaxis with steroids and antihistamines.
  • Skin testing confirmed hypersensitivity to 5-FU, even without prior exposure.

Findings:

  • A continuous intravenous desensitization protocol was successfully employed.
  • The protocol involved sequential increments in infusion rates and drug concentrations.
  • This approach enabled safe administration of 5-FU despite documented hypersensitivity.

Implications:

  • This desensitization strategy offers a viable option for managing 5-FU hypersensitivity in cancer patients.
  • The protocol may be adaptable for desensitizing patients to other chemotherapeutic agents.
  • Preserving 5-FU treatment options is crucial for patients with limited therapeutic alternatives.

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