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Leuk Lymphoma. 2019 Jul 1:1-6. doi: 10.1080/10428194.2019.1633640. [Epub ahead of print]

High prevalence of antibiotic allergies in cladribine-treated patients with hairy cell leukemia - lessons for immunopathogenesis and prescribing.

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a Department of Infectious Diseases , Austin Health , Heidelberg , Australia.
b Department of Haematology , Peter MacCallum Cancer Centre , Melbourne , Australia.
c Department of Haematology , St Vincents Hospital , Melbourne , Australia.
d Department of Medicine , University of Melbourne , Melbourne , Australia.
e Department of Pharmacy , Austin Health , Heidelberg , Australia.
f Department of Haematology , Royal Melbourne Hospital , Melbourne , Australia.
g Department of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA.
h Department of Infectious Diseases , Peter MacCallum Cancer Centre , Melbourne , Australia.


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.


Hairy cell leukemia; allergy; antibiotics; cladribine; maculopapular exanthem

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