HISTAMINE RELEASE OF INTACT AND IgE-DEPRIVED BASOPHIL LEUCOCYTES IN CHILDREN WITH HYPERSENSITIVITY REACTIONS TO TENIPOSIDE (VM-26)

Abstract

Since 1980, Rigshospitalet's Paediatric Department has used teniposide (VM-26) primarily in the treatment of children with neuroblastoma and high-risk lymphoblastic leukaemia. A review of the files showed 11 cases of hypersensitivity up to the end of 1986. All the reactions, apart from one, occurred early into the infusion (<1 to 15 min), and after a varying number of previous courses. All the children recovered, but in 3 cases the acute course was critical. In order to elucidate the mechanism and to identify a possible allergen, in vitro investigations of histamine liberation of the basophil leucocytes were carried out by use of a glass microfibre method. Blood samples from 5 of the 11 cases,6 children exposed to VM-26 without reactions, and 12 healthy children without exposure at all, were tested. The results indicated, that VM-26 itself, and not its vehicle (Cremaphor), is a potent histamine liberator due to a toxic, dose-dependent reaction, and not to a type I (IgE-mediated) allergy.

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