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CASE REPORT
Year : 2019  |  Volume : 6  |  Issue : 4  |  Page : 184-187

Identification of docetaxel, cisplatin, and 5-fluorouracil regimen hypersensitivity by In vitro T-cell activation assay


1 Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan
2 Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital at Keelung and Chang Gung University College of Medicine, Taoyuan, Taiwan

Correspondence Address:
Dr. Yen-Min Huang
Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelung, No. 200, Lane 208, Jijin 1st Road, Keelung 20445
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCRP.JCRP_11_19

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An in vitro T-cell activation assay measuring granulysin and granzyme B has been used to identify the drug hypersensitivity of common causative drugs, but not of chemotherapeutic drugs. Both granulysin and granzyme B are cytotoxic molecules involved in skin eruptions during drug hypersensitivity. Herein, we report the first clinical application of an in vitro T-cell activation assay to identify the causative agent in docetaxel, cisplatin, and 5-fluorouracil (5-FU)-related hypersensitivity in a patient with head-and-neck cancer. A significant increase in granulysin and granzyme B was observed for 5-FU rather than for docetaxel or cisplatin. Despite several limitations, we were still able to pinpoint 5-FU as the culprit drug in a chemotherapy combination without further drug rechallenge in our patient. In conclusion, an in vitro T-cell activation assay measuring granulysin and granzyme B can be a safe and alternative tool to determine the causative agent of hypersensitivity reactions in cancer patients who need combination chemotherapy.


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