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Oral Desensitization Prevents Recurrent Imatinib (Gleevec) Rash

Posted on: 09/12/2006

Oral Desensitization Prevents Recurrent Imatinib Rash

NEW YORK (Reuters Health) Aug 31 - Oral desensitization can be used to prevent the recurrent rash that prevents therapy with imatinib in some patients with leukemia, according to a report in the August Annals of Allergy, Asthma & Immunology.

"A single case has been reported of a protracted, progressive challenge using weekly dosing increments, but no universally established algorithm exists for managing patients with adverse cutaneous reactions to imatinib," the authors explain.

Dr. Robert P. Nelson, Jr. and colleagues from Indiana University School of Medicine, Indianapolis, administered oral desensitization to 10 patients with leukemia who had a prior history of refractory rash associated with imatinib.

The 4-hour oral desensitization program started with a 10 ng dose in a supervised setting and progressed in nine steps to tablets of 2 to 100 mg, the report indicates.

All 10 patients tolerated the oral desensitization program, the authors report, and 8 patients were able to continue daily imatinib therapy without recurrent rash or other adverse effects.

Of the two remaining patients, one developed a diffuse rash 5 hours after the desensitization procedure, and one developed recurrent rash several days after desensitization.

"Observations of greater numbers of patients who undergo this procedure will be required to confirm the efficacy of oral desensitization and to illuminate the mechanism of rash development in patients with recurrent or recalcitrant rash," the researchers say.

"Oral desensitization appears to be an option for patients with recurrent cutaneous drug reactions to imatinib, which may permit clinicians to safely administer imatinib to some patients with leukemia who experience adverse cutaneous reactions to this life-prolonging medication," the investigators conclude.

Ann Allergy Asthma Immunol 2006;97:216-222.

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