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. 2022 May 23;20(1):7.
doi: 10.1186/s12948-022-00173-0.

Cutaneous reaction to ifosfamide plus mesna treated with desensitization challenge: a case report

Ana Delgado-Prada  1 , Julián Borrás  2 , Roxana Farzanegan  3 , María Cruz Torres Gorriz  3 , Adrián Germán-Sánchez  3 , Raquel Cervera Aznar  3 , Isabela Raducan  3 , Jose Vicente Castelló  3 , Alfredo Sanchez-Hernandez  4 , Ernesto Enrique  3
Affiliations

Cutaneous reaction to ifosfamide plus mesna treated with desensitization challenge: a case report

Ana Delgado-Prada et al. Clin Mol Allergy. .

Abstract

Background: Ifosfamide is an alkylating agent used in the treatment of a wide range of tumours. Because of known side effects it is usually administered in combination with mesna, a thiol agent with uroprotective activity, to reduce them and increase the therapeutic dose. The most frequently administered regimens for ifosfamide are fractionated doses for 3 to 5 days, high-dose intravenous bolus, and continuous infusion over 24 to 72 h. Hypersensitivity reactions to ifosfamide plus mesna are not frequently described in the literature. Moreover, no reports exist concerning desensitization for this chemotherapy combination.

Case presentation: A 47-year-old man with stage IV renal sarcoma was treated with the combination of ifosfamide and mesna every 3 weeks in a 4-consecutive-day infusion protocol. During the second cycle of chemotherapy, he presented acute cutaneous symptoms. A 12-step desensitization protocol was proposed in view of the lack of knowledge of the possible hypersensitivity reactions to this combination of chemotherapy agents, and the multiple difficulties found during the study of the case.

Conclusions: The 12-step desensitization protocol was well tolerated. Therefore, it is an appropriate and safe option in the case of suspected allergy to ifosfamide plus mesna.

Keywords: Chemotherapy; Desensitization; Ifosfamide plus mesna.

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Conflict of interest statement

The authors declare that they have no competing interests.

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