由于免疫受损和药理复杂性等多种因素，药物过敏反应在儿科血液肿瘤患者中很常见。发烧可能意味着严重的迟发型超敏反应，例如伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）或药物诱发的超敏反应综合征（DIHS）。发热作为一种对化疗药物的孤立性超敏反应的病因尚不完全清楚。在这里，我们报告了三名患有颅内肿瘤的儿童在以长春花生物碱为基础的化疗后经历复发性发热反应，并通过半胱氨酰白三烯受体拮抗剂治疗缓解。我们介绍了一系列患有不同颅内肿瘤的儿科患者，他们在接受长春花生物碱的多个疗程后出现反复发热发作为基础的化疗。治疗包括预防性和化疗后给予半胱氨酰白三烯受体拮抗剂，以预防发热发作，并能够在不修改方案或脱敏的情况下完成化疗方案。所有三名患者都经历了与长春花生物碱迟发型超敏反应一致的发热。预防性使用白三烯拮抗剂孟鲁司特成功地预防了发烧复发，从而可以不间断地完成化疗疗程。我们的研究结果表明，白三烯拮抗剂孟鲁司特可能有助于控制儿科患者对长春花生物碱迟发型超敏反应的发烧。需要进一步研究来阐明药物引起的发热反应的潜在机制和白三烯途径。© 2024 Kidon、Haj Yahia、Abebe-Campino、Agmon-Levin 和 Yelon。

Drug hypersensitivity reactions are common in pediatric hemato-oncology patients due to multiple factors including immune compromise and pharmacological complexities. Fever can signify severe delayed-type hypersensitivity reactions such as drug reaction with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity syndrome (DIHS). The etiology of fever as an isolated hypersensitivity reaction to chemotherapeutic agents not fully understood. Here, we report three children with intracranial neoplasms experiencing recurrent febrile reactions following Vinca alkaloid-based chemotherapy, mitigated by cysteinyl leukotriene receptor antagonist therapy.We present a series of pediatric patients with diverse intracranial neoplasms who developed recurrent fever episodes after multiple courses of Vinca alkaloid-based chemotherapy. Treatment involved prophylactic and post-chemotherapy administration of a cysteinyl leukotriene receptor antagonist to prevent fever episodes and enable completion of chemotherapy regimens without protocol modifications or desensitization.All three patients experienced fever consistent with delayed-type hypersensitivity reactions to Vinca alkaloids. Prophylactic use of the leukotriene antagonist Montelukast successfully prevented fever recurrence, allowing uninterrupted completion of chemotherapy courses.Our findings suggest that Montelukast, a leukotriene antagonist, may be beneficial in managing fever as a delayed-type hypersensitivity reaction to Vinca alkaloids in pediatric patients. Further research is warranted to elucidate the underlying mechanisms and leukotriene pathways involved in drug-induced fever reactions.© 2024 Kidon, Haj Yahia, Abebe-Campino, Agmon-Levin and Yelon.