The Complex Clinical Picture of Presumably Allergic Side Effects to Cytostatic Drugs: Symptoms, Pathomechanism, Reexposure, and Desensitization
The Complex Clinical Picture of Presumably Allergic Side Effects to Cytostatic Drugs: Symptoms, Pathomechanism, Reexposure, and Desensitization
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DOI：
10.1016/j.mcna.2010.03.002
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发表时间：
2010-07-01
影响因子：
5.9
通讯作者：
Pagani, Mauro
中科院分区：
文献类型：
--
作者：
Pagani, Mauro
用于治疗不同类型癌症的药物数量不断增加，实际上超过 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超敏反应有关，并且其给药量的不断增加导致这些不良反应发生率的增加，从而成为临床医生面临的相关问题。过敏反应在铂化合物、L-天冬酰胺酶、紫杉烷类、丙卡巴肼和表鬼臼毒素中很常见，而在其他化疗药物中则不常见，但总是有可能发生。详细讨论了与个别药物相关的反应。这些超敏反应的机制涉及 IgE 介导的超敏反应、非过敏性超敏反应和一些病因不明的反应。需要更多的研究来更好地理解、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的癌症患者。
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.