Successful case of deferasirox slow desensitization in adults.

Autor:	Basa Akdogan B; University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and., Koca Kalkan I; University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and., Koycu Buhari G; University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and., Ozdedeoğlu O; University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and., Ates H; University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and., Aksu K; University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, and., Oner Erkekol F; Yıldırım Beyazıt University, Division of Immunology and Allergy, Department of Chest Diseases, Ankara, Türkiye.
Jazyk:	angličtina
Zdroj:	Allergologie select [Allergol Select] 2024 Aug 19; Vol. 8, pp. 278-282. Date of Electronic Publication: 2024 Aug 19 (Print Publication: 2024).
DOI:	10.5414/ALX02501E
Abstrakt:	Introduction: When deferasirox is used in iron chelation therapy, maculopapular rash occurs in 10% of patients, but there is no accepted and implemented protocol for the management of these drug reactions in adults. Case Report: A 23-year-old woman diagnosed with thalassemia major is presented. She had taken 1,500 mg oral deferasirox for 1 week. Five hours after the last dose, a pruritic maculopapular rash developed on the body, face, and hands. The rash spread to the whole body within 3 days. The absolute necessity for the patient to take the drug was clarified by the hematology department. The patient's history was evaluated. A delayed-type hypersensitivity reaction due to deferasirox was considered. Management: The slow desensitization protocol described in the literature and applied on a case-by-case basis in pediatric patients was modified to shorten the duration by determining appropriate doses for the current preparation. The desensitization process was started with 1/100,000 of the total dose and the therapeutic dose was reached with a 2- to 2.5-fold increase in dose. No pre-medication was applied. During the procedure, at a low dose of 0.1 mg, local flushing and erythema was observed around the auricle on the face. The reaction did not progress. Conclusion: Slow desensitization protocol for oral deferasirox was successfully applied in an adult patient. Competing Interests: The authors acknowledge that they do not have any conflict of interest regarding the study. Table 1.Deferasirox slow desensitization protocols. Bruner et al. [4] protocolOur protocolTime intervals (days)Dose (mg)Dose (mg)Dose (mL)30.050.05Solution Ba 0.5 mL40.10.1Solution B 1 mL30.20.2Solution B 2 mL40.50.5Solution B 5 mL311Solution Ab 1 mL422Solution A 2 mL345Solution A 5 mL4810Solution A 10 mL31620Solution A 20 mL43240Solution A 40 mL36480Solution A 80 mL4125150Solution A 150 mL32502501 tablet45005002 tablets77507503 tablets71,0001,5006 tablets71,500 aA suspension was made by 1 : 10 dilution of solution A to a final concentration of 0.1 mg/mL (solution B); bA suspension was prepared by dissolving 1 tablet of deferasirox (250 mg) into a volume of 250 mL of water to a final concentration of 1 mg/mL (solution A). (© Dustri-Verlag Dr. K. Feistle.)
Databáze:	MEDLINE
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