High prevalence of antibiotic allergies in cladribine-treated patients with hairy cell leukemia - lessons for immunopathogenesis and prescribing.

Meher-Homji Z, Tam CS, Siderov J, Seymour JF, Holmes NE, Chua KYL, Phillips EJ, Slavin MA, Trubiano JA
Leuk Lymphoma. 2019 60 (14): 3455-3460

PMID: 31256738 · PMCID: PMC6928424 · DOI:10.1080/10428194.2019.1633640

The relationship between hematological malignancy and chemotherapy on the prevalence of antibiotic allergy label (AAL) is ill-defined. We performed a multicenter retrospective case-control study comparing AAL rates among cladribine-treated hairy cell leukemia (C-HCL) cases, non-HCL cladribine-treated controls (control-1), and fludarabine-treated controls (control-2). The prevalence of AALs in C-HCL patients was 60%, compared with control-1 (14%,  < .01) and control-2 patients (25%,  < .01). The predominant phenotype was maculopapular exanthem (92%). The drugs implicated in AAL causality in C-HCL patients included beta-lactams (81%), trimethoprim-sulfamethoxazole (58%), and allopurinol (69%). C-HCL patients demonstrate high rates of AAL, potentially due to immune dysregulation, impacting beta-lactam utilization.

MeSH Terms (19)

Adult Aged Anti-Bacterial Agents Antineoplastic Combined Chemotherapy Protocols Australia Case-Control Studies Cladribine Drug Hypersensitivity Female Follow-Up Studies Humans Leukemia, Hairy Cell Male Middle Aged Prevalence Prognosis Retrospective Studies Survival Rate Vidarabine

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