PMID- 26161019
OWN - NLM
STAT- MEDLINE
DCOM- 20160316
LR  - 20220409
IS  - 2005-6648 (Electronic)
IS  - 1226-3303 (Print)
IS  - 1226-3303 (Linking)
VI  - 30
IP  - 4
DP  - 2015 Jul
TI  - Allopurinol hypersensitivity syndrome in patients with hematological 
      malignancies: characteristics and clinical outcomes.
PG  - 521-30
LID - 10.3904/kjim.2015.30.4.521 [doi]
AB  - BACKGROUND/AIMS: Allopurinol is a urate-lowering agent that is commonly used to 
      prevent chemotherapy-related hyperuricemia. Allopurinol hypersensitivity syndrome 
      (AHS) is a disorder involving multiple organs, which may be accompanied by 
      cutaneous adverse reactions. We identified the characteristics and clinical 
      outcomes of chemotherapy-associated AHS in patients with hematological 
      malignancies. METHODS: This retrospective single-center study included 26 AHS 
      patients (11 with and 15 without hematological malignancies) admitted to Seoul 
      St. Mary's Hospital. AHS was defined using the criteria of Singer and Wallace. 
      Comparisons were made using the Mann-Whitney U test and Fisher exact test as 
      appropriate. RESULTS: In patients with a hematological malignancy and AHS, 
      statistically significant differences were observed in terms of younger age at 
      onset; shorter duration of exposure; higher starting and maintenance doses of 
      allopurinol; lower incidence of eosinophilia, leukocytosis, and underlying renal 
      insufficiency; and more frequent occurrence of fever compared to AHS patients 
      without a hematological malignancy. Two AHS patients with a hematological 
      malignancy were examined for human leukocyte antigen (HLA)-B typing, but neither 
      patient harbored the HLA-B*5801 allele. All of the patients ceased allopurinol 
      treatment, with most patients making a full recovery. Two patients in the study 
      died; however, these deaths were unrelated to AHS. One patient developed serious 
      sequelae of AHS that required hemodialysis. CONCLUSIONS: Physicians who prescribe 
      allopurinol for the prevention of chemotherapy-related hyperuricemia should be 
      aware of the unique risk of AHS, even in patients with hematological malignancies 
      who do not have known risk factors for AHS. Novel urate-lowering agents should be 
      considered alternative treatments.
FAU - Min, Hong Ki
AU  - Min HK
AD  - Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's 
      Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
FAU - Lee, Boin
AU  - Lee B
AD  - Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The 
      Catholic University of Korea, Seoul, Korea.
FAU - Kwok, Seung-Ki
AU  - Kwok SK
AD  - Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's 
      Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
FAU - Ju, Ji Hyeon
AU  - Ju JH
AD  - Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's 
      Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
FAU - Kim, Wan-Uk
AU  - Kim WU
AD  - Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's 
      Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
FAU - Park, Young Min
AU  - Park YM
AD  - Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The 
      Catholic University of Korea, Seoul, Korea.
FAU - Park, Sung-Hwan
AU  - Park SH
AD  - Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's 
      Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150629
PL  - Korea (South)
TA  - Korean J Intern Med
JT  - The Korean journal of internal medicine
JID - 8712418
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Glucocorticoids)
RN  - 0 (Gout Suppressants)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Allopurinol/*adverse effects
MH  - Antineoplastic Agents/*adverse effects
MH  - Comorbidity
MH  - Dose-Response Relationship, Drug
MH  - Drug Hypersensitivity Syndrome/diagnosis/drug therapy/*etiology
MH  - Female
MH  - Glucocorticoids/therapeutic use
MH  - Gout Suppressants/*adverse effects
MH  - Hematologic Neoplasms/*drug therapy
MH  - Humans
MH  - Hyperuricemia/chemically induced/diagnosis/*prevention & control
MH  - Male
MH  - Medical Records
MH  - Middle Aged
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC4497340
OTO - NOTNLM
OT  - Allopurinol hypersensitivity syndrome
OT  - Hematologic neoplasms
COIS- Conflict of interest: No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2015/07/15 06:00
MHDA- 2016/03/17 06:00
PMCR- 2015/07/01
CRDT- 2015/07/11 06:00
PHST- 2014/05/21 00:00 [received]
PHST- 2014/07/10 00:00 [revised]
PHST- 2014/07/28 00:00 [accepted]
PHST- 2015/07/11 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/03/17 06:00 [medline]
PHST- 2015/07/01 00:00 [pmc-release]
AID - 10.3904/kjim.2015.30.4.521 [doi]
PST - ppublish
SO  - Korean J Intern Med. 2015 Jul;30(4):521-30. doi: 10.3904/kjim.2015.30.4.521. Epub 
      2015 Jun 29.