利妥昔单抗引起过敏反应2例

2例患者静脉滴注利妥昔单抗引起过敏反应。例1为61岁女性非霍奇金淋巴瘤患者,为行化疗入院。入院当日给予利妥昔单抗600mg,1次/d静脉滴注。2h后患者出现咽部不适,并伴有气急、畏寒、发热、寒战,T37.8℃。停用利妥昔单抗,给予地塞米松静脉注射,2h后症状缓解。再次给予利妥昔单抗静脉滴注,约半小时后患者出现吞咽困难、气急、大汗淋漓,BP80/52mmHg。再次停用利妥昔单抗,并给于抗过敏治疗,4h后症状好转。例2为52岁女性慢性淋巴细胞白血病患者,因病情进展行氟达拉宾＋利妥昔单抗联合化疗。给予利妥昔单抗600mg,1次/d静脉滴注。约半小时后患者出现胸闷、气急、喉咙紧缩感、口唇紫绀,并伴有畏寒、寒战,双肺散在哮鸣音。停用利妥昔单抗,给予吸氧及抗过敏治疗,2h后症状缓解。次日改用环磷酰胺＋氟达拉宾联合化疗,未再出现上述症状。

Anaphylactic reactions induced by rituximab in two patients

Anaphylactic reactions appeared in two patients after administration of an IV infusion of rituximab.Patient 1,61-year-old women with non-Hodgkin lymphoma,was hospitalized for chemotherapy.On day of admission,the patient received an IV infusion of rituximab 600 mg once daily.Two hours later,she developed throat discomfort followed by short of breath,chilliness,fever,shivers and her temperature was 37.8℃.Rituximab was withdrawn and an IV dexamethasone was given.Her symptoms relieved after two hours.About half an hour after restarting an IV infusion of rituximab,she experienced dysphyagia,short of breath,polyhydrosis with a BP of 80/52 mm Hg.Rituximab was stopped again and anti-allergic therapy was given.Four hours later,her symptoms improved.Patient 2,52-year-old women with chronic lymphocytic leukemia,was treated with combined chemotherapy with fludarabine and rituximab.She received an IV infusion of rituximab 600 mg once daily.About half an hour later,the patient presented with chest distress,short of breath,tightened throat,lip cyanosis accompanied by chilliness,shivers,and diffuse wheezing in both lungs.Rituximab was discontinued and oxygen inhalation and anti-allergic treatments were given.Two hours later,her symptoms relieved.On second day,she was administrated with combined chemotherapy with cyclophosphamide and fludarabine,the above-described symptoms did not recur.