Austin Health

Title
High prevalence of antibiotic allergies in cladribine-treated patients with hairy cell leukemia - lessons for immunopathogenesis and prescribing.
Publication Date
2019-07-01
Author(s)
Meher-Homji, Zaal
Tam, Constantine S
Siderov, Jim
Seymour, John Francis
Holmes, Natasha E
Chua, Kyra Y L
Phillips, Elizabeth J
Slavin, Monica A
Trubiano, Jason
Subject
Hairy cell leukemia
allergy
antibiotics
cladribine
maculopapular exanthem
Type of document
Journal Article
OrcId
0000-0003-4636-3678
0000-0002-9759-5017
0000-0003-2188-6835
0000-0001-8501-4054
0000-0002-8443-314X
0000-0002-5111-6367
DOI
10.1080/10428194.2019.1633640
Abstract
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%, p < .01) and control-2 patients (25%, p < .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.
Link
Citation
Leukemia & Lymphoma 2019; 60(14): 3455-3460
Jornal Title
Leukemia & Lymphoma

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