SUCCESSFUL PARENTERAL DESENSITIZATION TO PACLITAXEL

Background: Paclitaxel, a member of a new class of antineoplastic agen ts called die taxanes, has been associated with anaphylactoid reaction s. Objective: We report a case of successful parental desensitization to paclitaxel. Methods: Desensitization was performed with serial 10-f old dilutions (up to 1:100,000) of paclitaxel in sufficient volume to administer successive doses of 1, 2, 4 and 8 ml. Basophil histamine re lease tests were performed with paclitaxel alone, vehicle alone, and p aclitaxel and vehicle combined to determine which agent was responsibl e for the anaphylactoid reactions. Results: After parental desensitiza tion was performed, the patient was able to tolerate infusion of pacli taxel without complications or. need for antihistamines or steroids. B asophil histamine release occurred only with paclitaxel and not with t he vehicle. Conclusions: Successful parenteral desensitization to pacl itaxel can be achieved, it is paclitaxel, and not its vehicle, that is most likely responsible for anaphylactoid reactions inpatients underg oing treatment.