Clinical characteristics and literature analysis on pegylated recombinant human granulocyte colony stimulating factor associated anaphylaxis
Objective To explore the clinical characteristics and treatment of anaphylaxis associated with pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF).Methods We reported the diagnosis and treatment of two breast cancer patients with grade 3 anaphylaxis after PEG-rhG-CSF treatment in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,and the other clinical cases collected from PubMed,Embase,CNKI,and Wanfang database.All of the cases were analyzed by descriptive statistical analysis.Results A total of 10 patients were included in the analysis,male to female ratio was 3∶7 at the median age of 52 years old.The primary disease involved 7 cancer species.Of the 10 patients,7 had anaphylactic shock,9 patients were allergic after initial use,and one patient at our hospital was allergic after the 4th use.2 cases recurred within a few days after discontinuation of the initial anti-allergic therapy,and 2 cases at our hospital were treated with antihistamines and corticosteroids,which may have prevented recurrence of anaphylactic shock.Conclusion Pretreatment with glucocorticoid before PEG-rhG-CSF can reduce the severity of adverse reactions.When an allergic reaction of 3 to 4 level occurs,epinephrine should be given as soon as possible.Other therapies should be given including dexamethasone and diphenhydramine for anti-allergy,supplemented by fluid rehydration,oxygen inhalation,hypertension and other symptomatic treatment to achieve good patient's prognosis.
pegylated recombinant human granulocyte colony stimulating factoranaphylaxisdrug-related adverse reactions
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