内容紹介
Summary
Twenty-one patients underwent a drug-induced lymphocyte stimulation test(DLST)with anti-cancer drugs suspected as causative agents of allergy between January 1, 2013, and December 31, 2017, at Ichinomiya Municipal Hospital, and 7(33.3%)and 14 patients were positive and negative, respectively. Moreover, only 2 out of 21 people had a low value in lymphocyte blast transformation test induced by phytohemagglutinin, and their immune ability was maintained. Two patients suspected of drug eruption were re-administered after a positive determination. Letrozole was re-administered in 1 patient, but exemestane was administered after the patient relapsed. The other patient received lenalidomide in combination with dose-reduction and prednisolone(PSL), and the patient did not relapse. Seven patients were re-administered after negative determination, and none of them relapsed. These results confirmed that re-administration was possible depending on the type of side effects even in DLST positive cases; however, it was necessary to take various precautions. Moreover, DLST results were an index for finding the cause, and it is important to consider other diagnostic methods carefully during re-administration.
要旨
一宮市立市民病院にて2013年1月1日～2017年12月31日の間に,抗がん剤を被疑薬として薬剤リンパ球刺激試験(DLST)を行った患者は21名で,DLST陽性7名(33.3%),陰性は14名であった。また,PHA値について検討した結果では21名中2名のみが低値であり,免疫能は保たれていた。陽性判定後に再投与されていたのは薬疹疑いの2名で,1名はletrozoleを再投与したが再燃にてexemestaneへ変更,もう1名はlenalidomideを減量およびprednisolone(PSL)併用にて投与し再燃はなかった。陰性判定後の再投与は7名で,いずれも再燃はなかった。今回の調査から,DLST陽性例においても副作用の種類や各種対策により再投与可能なケースがあることが確認された。しかしDLST結果は原因検索の一指標であり,再投与においては他の診断法を加味し慎重に検討することが重要である。
目次
Twenty-one patients underwent a drug-induced lymphocyte stimulation test(DLST)with anti-cancer drugs suspected as causative agents of allergy between January 1, 2013, and December 31, 2017, at Ichinomiya Municipal Hospital, and 7(33.3%)and 14 patients were positive and negative, respectively. Moreover, only 2 out of 21 people had a low value in lymphocyte blast transformation test induced by phytohemagglutinin, and their immune ability was maintained. Two patients suspected of drug eruption were re-administered after a positive determination. Letrozole was re-administered in 1 patient, but exemestane was administered after the patient relapsed. The other patient received lenalidomide in combination with dose-reduction and prednisolone(PSL), and the patient did not relapse. Seven patients were re-administered after negative determination, and none of them relapsed. These results confirmed that re-administration was possible depending on the type of side effects even in DLST positive cases; however, it was necessary to take various precautions. Moreover, DLST results were an index for finding the cause, and it is important to consider other diagnostic methods carefully during re-administration.
要旨
一宮市立市民病院にて2013年1月1日～2017年12月31日の間に,抗がん剤を被疑薬として薬剤リンパ球刺激試験(DLST)を行った患者は21名で,DLST陽性7名(33.3%),陰性は14名であった。また,PHA値について検討した結果では21名中2名のみが低値であり,免疫能は保たれていた。陽性判定後に再投与されていたのは薬疹疑いの2名で,1名はletrozoleを再投与したが再燃にてexemestaneへ変更,もう1名はlenalidomideを減量およびprednisolone(PSL)併用にて投与し再燃はなかった。陰性判定後の再投与は7名で,いずれも再燃はなかった。今回の調査から,DLST陽性例においても副作用の種類や各種対策により再投与可能なケースがあることが確認された。しかしDLST結果は原因検索の一指標であり,再投与においては他の診断法を加味し慎重に検討することが重要である。